Individual provider Active NPI

Brock Aaron Droll, DMD, MS

  • Endodontics
  • Sartell, MN
National Provider Identifier
1205164704
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D13005 Issued in MN
Practice address
1900 Kruchten CT S Ste 100
Sartell, MN 56377-2701
Phone
(320) 656-1456
NPI assigned
Nov 23, 2009
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 30.023036 OH
Endodontics 1223E0200X D13005 MN Primary

Addresses

Primary practice location

1900 Kruchten CT S Ste 100
Sartell, MN 56377-2701

Mailing address

1900 Kruchten CT S Ste 100
Sartell, MN 56377-2701
Phone (320) 656-1456

Other practice location 1

305 W 12th Ave
Postle Hall Room 3041A
Columbus, OH 43210-1267
Phone (614) 292-5399

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000227 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6406007632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30.023036OHMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Lakes Endodontics PA Endodontics Current Accepting new patients
Central Minnesota Endodontics, PA Endodontics PastSince Dec 6, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1205164704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 KRUCHTEN CT S STE 100",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772701",
            "telephone_number": "320-656-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 KRUCHTEN CT S STE 100",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772701",
            "telephone_number": "320-656-1456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave",
            "address_2": "Postle Hall Room 3041A",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-292-5399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DROLL",
        "first_name": "BROCK",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.023036",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D13005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.