Individual provider Active NPI

David William Laurin, DDS

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1235212234
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0003228 Issued in WI
Practice address
Department of Vererans Affairs Medical Center
1 Veterans Drive
Minneapolis, MN 55417-2300
Phone
(612) 467-2000
Fax
(612) 727-5669
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 0003228 WI Primary

Addresses

Primary practice location

Department of Vererans Affairs Medical Center
1 Veterans Drive
Minneapolis, MN 55417-2300

Mailing address

2817 Woods TRL S
Burnsville, MN 55306-5239
Phone (952) 898-2092

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
I20160302002842 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0143406025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003228WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235212234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 WOODS TRL S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065239",
            "telephone_number": "952-898-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF VERERANS AFFAIRS MEDICAL CENTER",
            "address_2": "1 VETERANS DRIVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172300",
            "telephone_number": "612-467-2000",
            "fax_number": "612-727-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIN",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "0003228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.