NPIMap

Organization Active NPI

Justin T. Ostrem D.D.S. PA

  • General Practice Dentistry
  • Plymouth, MN
National Provider Identifier
1124773460
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JUSTIN T. OSTREM D.D.S. PA
Practice address
9655 Schmidt Lake Rd Ste 200
Plymouth, MN 55442-4530
Phone
(763) 536-1272
NPI assigned
Feb 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Dr. Justin T Ostrem, DDSNPI 1831267467
Title
Owner
Phone
(763) 536-1272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9655 Schmidt Lake Rd Ste 200
Plymouth, MN 55442-4530

Mailing address

9655 Schmidt Lake Rd Ste 200
Plymouth, MN 55442-4530
Phone (763) 536-1272

National Provider Directory

National Provider Directory

Locations

9655 Schmidt Lake Rd
Ste 200
Plymouth, MN 55442
Phone (763) 536-1272

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1124773460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9655 SCHMIDT LAKE RD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424530",
            "telephone_number": "763-536-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 SCHMIDT LAKE RD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424530",
            "telephone_number": "763-536-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN T. OSTREM D.D.S. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "OSTREM",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-536-1272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.