Individual provider Active NPI

Steven T Maroney, DDS

  • General Practice Dentistry
  • Edina, MN
National Provider Identifier
1003136003
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12808 Issued in MN
Practice address
5100 Eden Ave
#209
Edina, MN 55436-2337
Phone
(952) 929-0641
Fax
(952) 929-1802
NPI assigned
Jun 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12808 MN Primary

Addresses

Primary practice location

5100 Eden Ave
#209
Edina, MN 55436-2337

Mailing address

6600 France Ave S
#415
Edina, MN 55435-1805
Phone (952) 929-0641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D12808MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Cosmetic Gentle Dentistry, LTD. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1003136003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "address_2": "#415",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-929-0641",
            "fax_number": "952-929-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 EDEN AVE",
            "address_2": "#209",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362337",
            "telephone_number": "952-929-0641",
            "fax_number": "952-929-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARONEY",
        "first_name": "STEVEN",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.