Jon Allen Heezen, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

212 3Rd St
Tracy, MN 56175-1214

Phone

(605) 530-5031

NPI assigned

May 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Prairie Lakes Family Dentistry

  • General Practice Dentistry
  • Tracy, MN
  • NPI 1780453589
  NPD Authorized official
• Prairie Lakes Family Dentistry

  • General Practice Dentistry
  • Tracy, MN
  • NPI 1821946807
  NPD

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1013276252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 191ST ST",
            "city": "SLAYTON",
            "state": "MN",
            "postal_code": "561721937",
            "telephone_number": "605-530-5031",
            "fax_number": "507-763-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 3RD ST",
            "city": "TRACY",
            "state": "MN",
            "postal_code": "561751214",
            "telephone_number": "605-530-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEZEN",
        "first_name": "JON",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Deprez, LICSW
• Engelkes, LLC
• Mikaela Elizabeth Erickson, PA-C
• Denise Anne Evers, D.C.
• Mark Allen Evers
• Helping to Heal, Inc.
• Hewmaks Inc
• Barbra Jo Hughes, LICSW
• Samantha Anita Hurst, PHARMD
• Zachariah Dale Iverson, PHARM.D.

• Student in an Organized Health Care Education/Training Program in Tracy, MN
• Providers in Tracy, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.