Gene Gerald Dvoracek, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7993 Issued in MN

Practice address

12 Bridge SQ
Suite 106
Anoka, MN 55303-2493

Phone

(763) 421-4002

Fax

(763) 421-4006

NPI assigned

Nov 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anoka Dental PLLC

  • Dentist
  • Anoka, MN
  • NPI 1912458969
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174699888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRIDGE SQ",
            "address_2": "PO BOX 713",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032493",
            "telephone_number": "763-421-4002",
            "fax_number": "763-421-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BRIDGE SQ",
            "address_2": "SUITE 106",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032493",
            "telephone_number": "763-421-4002",
            "fax_number": "763-421-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORACEK",
        "first_name": "GENE",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D7993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DRS. Johnson and Yseth, P.a.
• Bridget Ann Duerr, LMT
• Jessica Lynn Duerr, L.AC.
• Adrian D Duffy, M.D.
• Eileen J. Duffy, M.D.
• Alma Dzafic, M.D.
• Minerva Echabu
• Julie Michelle Edinger, APRN
• Shannon Ehlke, PSYD, LP
• Jami Eilers, MA, OT

• General Practice Dentistry in Anoka, MN
• Providers in Anoka, MN by specialty
• General Practice Dentistry in Minnesota

• 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.