Active NPI
Thomas Jason Nomeland, D.D.S.
- Dentist
- Faribault, MN
National Provider Identifier
1174628622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D11041
- Practice address
- 412 Heritage PL
Faribault, MN 55021-5248 - Phone
- (507) 334-7595
- NPI assigned
- Sep 13, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D11041 | MN | Primary |
Addresses
Primary practice location
412 Heritage PL
Faribault, MN 55021-5248
Mailing address
412 Heritage PL
Faribault, MN 55021-5248
Phone (507) 334-7595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1415467 | Other | MN | UNITED CONCORDIA |
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 |
|---|---|---|---|
| D11041 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Dental Professionals, Minnesota PC | Dentist | Past | Accepting new patients |
| Nomeland Dental LLC | Dentist | 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.
-
- Dentist
- Faribault, MN
- NPI 1427298637
-
- Dentist
- Faribault, MN
- NPI 1184847568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174628622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 HERITAGE PL",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550215248",
"telephone_number": "507-334-7595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 HERITAGE PL",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550215248",
"telephone_number": "507-334-7595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOMELAND",
"first_name": "THOMAS",
"middle_name": "JASON",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D11041",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1415467",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Faribault, 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.