Michael John Dickman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12425 Issued in MN

Practice address

1414 S Oak Ave Suite Five
Owatonna, MN 55060

Phone

(507) 451-2226

NPI assigned

Jun 13, 2007

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Owatonna Dental Care

  • General Practice Dentistry
  • Owatonna, MN
  • NPI 1538264874
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063616993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25123 885TH AVE",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559127381",
            "telephone_number": "507-438-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S OAK AVE SUITE FIVE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "55060",
            "telephone_number": "507-451-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKMAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Deranek, PHARMD
• Erin Devine
• Peyton Marie Devinny
• Casie Jo Devos, LICSW
• Molly Dickerson
• Eric Dillinger, OD, MS, BA
• Paige Leann Dinse, APRN, CNP
• Nicolle Dirksen
• Anh Xuan Thi DO, PHARM.D
• Larry Vernell Dodd, MA

• General Practice Dentistry in Owatonna, MN
• Providers in Owatonna, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.