Thomas Backenstose

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

THOMAS BACKENSTOSE

Practice address

417 Lincoln Ave NW
Faribault, MN 55021-4952

Phone

(507) 332-7608

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Anne Meyer

Title

Office Manager

Phone

(507) 332-7608

Specialties & licenses 1

Addresses

Other names 1

• Faribault Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Wiese, D.D.S.

  • Dentist
  • Faribault, MN
  • NPI 1104814029
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225196330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 LINCOLN AVE NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LINCOLN AVE NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214952",
            "telephone_number": "507-332-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS BACKENSTOSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-332-7608"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faribault Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Dentists House LLC
• The Emeralds at Faribault Assisted Living LLC
• The Emeralds at Faribault LLC
• Therapywerks PA
• Deborah Ann Thibodeau, RPH
• Jordan Thompson
• Thomas Thornton, ABS
• Peter Jon Thurnau
• Doreen Anne Tierney
• Angela Lynn Timm, DO

• General Practice Dentistry in Faribault, MN
• Providers in Faribault, 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 Aug 22, 2020; 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.