Active NPI
Wallace Earl Lunden III, DDS
- Dentist
- Richfield, MN
National Provider Identifier
1093767345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8483
- Practice address
- 1404 East 66TH Street
Richfield, MN 55423 - Phone
- (612) 866-9622
- Fax
- (612) 866-3877
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8483 | MN | Primary |
Addresses
Primary practice location
1404 East 66TH Street
Richfield, MN 55423
Mailing address
3901 Auburn Drive
Minnetonka, MN 55305
Phone (952) 938-8110
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8483 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1093767345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 AUBURN DRIVE",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "55305",
"telephone_number": "952-938-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 EAST 66TH STREET",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "55423",
"telephone_number": "612-866-9622",
"fax_number": "612-866-3877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDEN",
"first_name": "WALLACE",
"middle_name": "EARL",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "8483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- 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.