Individual provider Active NPI

D Grant Lewis, DDS

  • General Practice Dentistry
  • Edina, MN
National Provider Identifier
1215621313
Registry record updated Oct 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14897 Issued in MN
Practice address
3930 Sunnyside Rd the Dentist House of Edina
Edina, MN 55424
Phone
(952) 929-9131
Fax
(952) 929-3142
NPI assigned
Jun 5, 2023
Last updated
Oct 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14897 MN Primary

Addresses

Primary practice location

3930 Sunnyside Rd the Dentist House of Edina
Edina, MN 55424

Mailing address

3930 Sunnyside Rd the Dentist House of Edina
Edina, MN 55424
Phone (952) 929-9131

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
D14897MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles on-Site Dentistry Current Accepting new patients
Northstar Dentistry CurrentSince Dec 15, 2024 Accepting new patients

Locations

3930 Sunnyside Rd
Edina, MN 55424
Phone (412) 877-2288

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": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792972800000",
    "number": "1215621313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 SUNNYSIDE RD THE DENTIST HOUSE OF EDINA",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "952-929-9131",
            "fax_number": "952-929-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 SUNNYSIDE RD THE DENTIST HOUSE OF EDINA",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "952-929-9131",
            "fax_number": "952-929-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "D",
        "middle_name": "GRANT",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2026-10-26",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2026; 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.