Individual provider Active NPI

Andrew Mark Doroschak, D.D.S., M.S.

  • Endodontics
  • Burnsville, MN
National Provider Identifier
1013026053
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10388 Issued in MN
Practice address
625 E Nicollet Blvd
Suite 340
Burnsville, MN 55337-6734
Phone
(952) 435-0370
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 10388 MN Primary

Addresses

Primary practice location

625 E Nicollet Blvd
Suite 340
Burnsville, MN 55337-6734

Mailing address

625 E Nicollet Blvd
Suite 340
Burnsville, MN 55337-6734
Phone (952) 435-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216000701 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2769651348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Endodontics, LTD. Endodontics 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013026053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E NICOLLET BLVD",
            "address_2": "SUITE 340",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376734",
            "telephone_number": "952-435-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E NICOLLET BLVD",
            "address_2": "SUITE 340",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376734",
            "telephone_number": "952-435-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROSCHAK",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "10388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.