Individual provider Active NPI

Loyle D Raymond, DDS

  • General Practice Dentistry
  • Golden Valley, MN
National Provider Identifier
1215950746
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8479 Issued in MN
Practice address
7575 Golden Valley Road
Ste 240
Golden Valley, MN 55427-4571
Phone
(763) 525-0306
Fax
(763) 525-0885
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X D8479 MN Primary

Addresses

Primary practice location

7575 Golden Valley Road
Ste 240
Golden Valley, MN 55427-4571

Mailing address

7575 Golden Valley Road
Ste 240
Golden Valley, MN 55427-4571
Phone (763) 525-0306

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
I20160316001086 MN Order and Referring Only - DentistPractitioner - Dentist 0648576736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215950746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 GOLDEN VALLEY ROAD",
            "address_2": "STE 240",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274571",
            "telephone_number": "763-525-0306",
            "fax_number": "763-525-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 GOLDEN VALLEY ROAD",
            "address_2": "STE 240",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274571",
            "telephone_number": "763-525-0306",
            "fax_number": "763-525-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "LOYLE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D8479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.