Individual provider Active NPI

Rolan Milutinovic, DDS

  • Dentist
  • Wells, MN
National Provider Identifier
1073341319
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15179 Issued in MN
Practice address
150 3Rd St NW
Wells, MN 56097-1021
Phone
(507) 553-5085
NPI assigned
Jul 25, 2024
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15179 MN Primary

Addresses

Primary practice location

150 3Rd St NW
Wells, MN 56097-1021

Mailing address

901 E River Pkwy
Minneapolis, MN 55414-3105
Phone (773) 886-4905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D15179MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1073341319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E RIVER PKWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143105",
            "telephone_number": "773-886-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 3RD ST NW",
            "city": "WELLS",
            "state": "MN",
            "postal_code": "560971021",
            "telephone_number": "507-553-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILUTINOVIC",
        "first_name": "ROLAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wells, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.