Active NPI
Brandon J Ranvek, D.D.S
- General Practice Dentistry
- Rosemount, MN
National Provider Identifier
1134323280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D12403
- Practice address
- 14895 S Robert TRL
Rosemount, MN 55068-3108 - Phone
- (952) 423-2288
- Fax
- (952) 423-2203
- NPI assigned
- Jun 13, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D12403 | MN | Primary |
Addresses
Primary practice location
14895 S Robert TRL
Rosemount, MN 55068-3108
Mailing address
14895 S Robert TRL
Rosemount, MN 55068-3108
Phone (952) 423-2288
Other practice location 1
6600 excelsior blvd #101
st. louis park, MN 55426
Phone (952) 938-2740
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 |
|---|---|---|---|
| D12403 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, P.a. | Past | Accepting new patients | |
| St. Croix Valley Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Rosemount, MN
- NPI 1538598057
-
- Point of Service
- Rosemount, MN
- NPI 1619144540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1134323280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14895 S ROBERT TRL",
"city": "ROSEMOUNT",
"state": "MN",
"postal_code": "550683108",
"telephone_number": "952-423-2288",
"fax_number": "952-423-2203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14895 S ROBERT TRL",
"city": "ROSEMOUNT",
"state": "MN",
"postal_code": "550683108",
"telephone_number": "952-423-2288",
"fax_number": "952-423-2203"
}
],
"practiceLocations": [
{
"address_1": "6600 excelsior blvd #101",
"address_purpose": "LOCATION",
"city": "st. louis park",
"state": "MN",
"postal_code": "55426",
"country_code": "US",
"telephone_number": "952-938-2740",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANVEK",
"first_name": "BRANDON",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D12403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rosemount, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.