Individual provider Active NPI

Stephen Michael Sawyer, DDS

  • General Practice Dentistry
  • Mendota Heights, MN
National Provider Identifier
1043379514
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11939 Issued in MN
Practice address
720 Main St
Ste 213
Mendota Heights, MN 55118
Phone
(651) 209-9219
Fax
(763) 755-4305
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11939 MN Primary

Addresses

Primary practice location

720 Main St
Ste 213
Mendota Heights, MN 55118

Mailing address

720 Main St
Ste 213
Mendota Heights, MN 55118
Phone (651) 209-9219

Other identifiers 1

IdentifierTypeStateIssuer
956443800MedicaidMN

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
I20160414001339 MN Order and Referring Only - DentistPractitioner - Dentist 7719285386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11939MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sawyer Dental LLC 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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1043379514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 MAIN ST",
            "address_2": "STE 213",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "55118",
            "telephone_number": "651-209-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MAIN ST",
            "address_2": "STE 213",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "55118",
            "telephone_number": "651-209-9219",
            "fax_number": "763-755-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYER",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "956443800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota Heights, MN

Sources for this page

Verify at the official NPI Registry.