William W Heitzman

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT18 Issued in MN

Practice address

415 1St Ave E
Shakopee, MN 55379-1439

Phone

(952) 403-5149

Fax

(952) 403-5969

NPI assigned

Apr 30, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• True North Community Dental Clinic, LLC

  • General Practice Dentistry
  • Shakopee, MN
  • NPI 1073123030
  NPD

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134564552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791439",
            "telephone_number": "952-403-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791439",
            "telephone_number": "952-403-5149",
            "fax_number": "952-403-5969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 25th Ave S Ste 400",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541443",
            "country_code": "US",
            "telephone_number": "612-659-4908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEITZMAN",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healing Touch Home Care LLC
• Health Transport
• Heartstrings Unlimited, Inc.
• Kristie Lynn Heger, ATC
• Sandra M Heil, RDN, LD, MPH
• Coleen Sue Helberg, CRNA
• Rachel Lauren Henly, LICSW
• Ryan Herbel
• Leslie Michelle Hernandez
• Ashley Marie Herold

• Dental Therapist in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.