Alan Repak, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D15109 Issued in MN

Practice address

1090 Shingle Creek Xing
Brooklyn Center, MN 55430-2684

Phone

(651) 583-7256

NPI assigned

May 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Consultants LLC

  • General Practice Dentistry
  • Brooklyn Center, MN
  • NPI 1689038473
  NPD (past)

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1003665134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 DELAWARE ST SE APT 409",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143829",
            "telephone_number": "701-388-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 SHINGLE CREEK XING",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302684",
            "telephone_number": "651-583-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPAK",
        "first_name": "ALAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliable Special Transportation Services
• Rem Hennepin Inc
• Rem Hennepin, Inc.
• Rem Hennepin, Inc.
• Remen Healthcare LLC
• Rescare Minnesota, Inc.
• Rescare Minnesota, Inc.
• Rescare Minnesota, Inc.
• Rescare Minnesota, Inc.
• Rescare Minnesota, Inc.

• Dentist in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.