Individual provider Active NPI

Karen Dizon Competente, D.D.S.

  • General Practice Dentistry
  • Blaine, MN
National Provider Identifier
1093884280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11271 Issued in MN
Practice address
4255 Pheasant Ridge Dr NE
Suite 407
Blaine, MN 55449-4537
Phone
(763) 225-6100
Fax
(763) 225-6101
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 D11271 MN Primary

Addresses

Primary practice location

4255 Pheasant Ridge Dr NE
Suite 407
Blaine, MN 55449-4537

Mailing address

13908 52ND Ave N
Plymouth, MN 55446-1631
Phone (763) 208-6414

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
I20160119000188 MN Order and Referring Only - DentistPractitioner - Dentist 5193028660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Dental Partners, PLLC General Practice PastSince Mar 20, 2022 Accepting new patients
Associated Dental Past Accepting new patients
Northland Dental Partners, PLLC General Practice PastSince Mar 20, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093884280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13908 52ND AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554461631",
            "telephone_number": "763-208-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE",
            "address_2": "SUITE 407",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494537",
            "telephone_number": "763-225-6100",
            "fax_number": "763-225-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPETENTE",
        "first_name": "KAREN",
        "middle_name": "DIZON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.