Douglas Glen Walesheck, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7367 Issued in MN

Practice address

1346 Payne Ave
Saint Paul, MN 55101-3434

Phone

(651) 774-6085

Fax

(651) 774-2660

NPI assigned

Dec 12, 2005

Last updated

Jul 13, 2026By the provider in NPPES

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)

Enrolled

Practice roles

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.

• Inside Edge Dental PLLC

  dba East Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1114360492
  NPD (past)

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043295132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 PAYNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551013434",
            "telephone_number": "651-774-6085",
            "fax_number": "651-774-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 PAYNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551013434",
            "telephone_number": "651-774-6085",
            "fax_number": "651-774-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALESHECK",
        "first_name": "DOUGLAS",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D7367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.