Individual provider Active NPI

Brandon J Ranvek, D.D.S

  • General Practice Dentistry
  • Rosemount, MN
National Provider Identifier
1134323280
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12403 Issued in MN
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

Updated by the provider on Mar 17, 2018

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 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

LicenseStateTypeSpecialty
D12403MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.