Distinctive Eyewear LLC

Distinctive Eyewear LLC is a healthcare organization registered as Eyewear Supplier in Wayzata, MN, holding Type 2 (organization) NPI 1609958230 since 2006. The authorized official on file is Kelly Pettengill, Credentialing and Data Management.

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NPI	1609958230
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
Phone	7634167654
Fax	7634167634
Enumeration date	2006-10-20
Last updated in NPPES	2020-03-18

Authorized official

Name	Kelly Pettengill
Title	Credentialing and Data Management
Phone	7634167629

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
156FX1800X	Optician	Secondary	—	—
332H00000X	Eyewear Supplier	Primary	—	—

Copy-ready billing details

Provider: Distinctive Eyewear LLC
NPI: 1609958230
Taxonomy: 332H00000X (Eyewear Supplier)
Address: 250 CENTRAL AVE N STE 106, Wayzata, MN, 55391

Verify this record

Cross-check NPI 1609958230 against the authoritative CMS record: view Distinctive Eyewear LLC on the official NPPES registry .

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. Read the full guide or validate an NPI number.

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 2026-07-11. Provider record last updated 2020-03-18.