Active NPI
Kindra L Bratteig, D.D.S.
- Dentist
- Lindstrom, MN
National Provider Identifier
1003983107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11098
- Practice address
- 12245 Lindstrom LN
Lindstrom, MN 55045-9550 - Phone
- (651) 257-4471
- Fax
- (651) 257-2921
- NPI assigned
- Nov 30, 2006
- Last updated
- Jan 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11098 | MN | Primary |
Addresses
Primary practice location
12245 Lindstrom LN
Lindstrom, MN 55045-9550
Mailing address
12245 Lindstrom LN
Lindstrom, MN 55045-9550
Phone (651) 257-4471
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11098 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shipp Dental Care, LTD. | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Chisago City, MN
- NPI 1982721809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1003983107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12245 LINDSTROM LN",
"city": "LINDSTROM",
"state": "MN",
"postal_code": "550459550",
"telephone_number": "651-257-4471",
"fax_number": "651-257-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12245 LINDSTROM LN",
"city": "LINDSTROM",
"state": "MN",
"postal_code": "550459550",
"telephone_number": "651-257-4471",
"fax_number": "651-257-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRATTEIG",
"first_name": "KINDRA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2021-01-20",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "11098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lindstrom, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.