Individual provider Active NPI

Thomas Jason Nomeland, D.D.S.

  • Dentist
  • Faribault, MN
National Provider Identifier
1174628622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11041 Issued in MN
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1415467OtherMNUNITED 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

LicenseStateTypeSpecialty
D11041MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.