Active NPI
Stephanie Anne O'Brien Driessen, D.D.S
- Dentist
- Foley, MN
National Provider Identifier
1184036048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13368
- Practice address
- 311 Dewey St
Foley, MN 56329-8447 - Phone
- (320) 968-7062
- NPI assigned
- May 27, 2014
- Last updated
- May 27, 2014
- 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 | D13368 | MN | Primary |
Addresses
Primary practice location
311 Dewey St
Foley, MN 56329-8447
Mailing address
PO Box 649
Foley, MN 56329-0649
Phone (320) 968-7062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150528001051 | MN | Order and Referring Only - Dentist | 7618297995 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dewey Street Dental | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Foley, MN
- NPI 1285032136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1184036048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "FOLEY",
"state": "MN",
"postal_code": "563290649",
"telephone_number": "320-968-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 DEWEY ST",
"city": "FOLEY",
"state": "MN",
"postal_code": "563298447",
"telephone_number": "320-968-7062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRIESSEN",
"first_name": "STEPHANIE",
"middle_name": "ANNE O'BRIEN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Foley, MN
- Coborns Inc (Coborns Pharmacy #2002)
- County of Benton Ind School Dist 51
- Dean T Weber (Foley Medical Supply Co)
- Dewey Street Dental
- Brooke Lynne Doerscher
- Kyle Alexander Edwards
- Melissa Ann Erickson, CMT
- FMS Foley Medical Supply LLC
- Foley Area Care a Living at Home Block Nurse Program
- Foley Chiropractic Office, P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.