Active NPI
Lynda K Bangtson, DDS MS
- Dentist
- Maplewood, MN
National Provider Identifier
1164564753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D8638
- Practice address
- 1055 Highway 36 East
Maplewood, MN 55109 - Phone
- (651) 766-0100
- Fax
- (651) 415-0275
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D8638 | MN | Primary |
Addresses
Primary practice location
1055 Highway 36 East
Maplewood, MN 55109
Mailing address
1055 Highway 36 East
Maplewood, MN 55109
Phone (651) 766-0100
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8638 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164564753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 HIGHWAY 36 EAST",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "55109",
"telephone_number": "651-766-0100",
"fax_number": "651-415-0275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 HIGHWAY 36 EAST",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "55109",
"telephone_number": "651-766-0100",
"fax_number": "651-415-0275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGTSON",
"first_name": "LYNDA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D8638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.