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Distinctive Eyewear LLC

Eyewear Supplier in Wayzata, MN · enumerated 2006 · authorized official Kelly Pettengill, Credentialing and Data Management.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1609958230

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Registry record

Entity type Organization (Type 2)
Legal business name Distinctive Eyewear LLC
Other name <Unavail>
Practice address 250 Central Ave N Ste 106, Wayzata, MN, 55391
Fax (763) 416-7634
Enumeration date Oct 20, 2006
Last updated in NPPES Mar 18, 2020

Taxonomy & classification

156FX1800X Optician Eye and Vision Services Providers Secondary
332H00000X Eyewear Supplier Suppliers Primary

Authorized official

Name Kelly Pettengill
Title Credentialing and Data Management

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Distinctive Eyewear LLC located?
The practice location on file with NPPES is in Wayzata, MN.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-03-18. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-03-18.