Individual provider Active NPI

Oana R Ivan, DDS

  • Dentist
  • Minneapolis, MN
National Provider Identifier
1245323633
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11854 Issued in MN
Practice address
515 Delaware St SE
9-470 Moose Tower
Minneapolis, MN 55455-0357
Phone
(612) 626-5161
Fax
(612) 626-1496
NPI assigned
Sep 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11854 MN Primary

Addresses

Primary practice location

515 Delaware St SE
9-470 Moose Tower
Minneapolis, MN 55455-0357

Mailing address

515 Delaware St SE
9-470 Moose Tower
Minneapolis, MN 55455-0357
Phone (612) 626-5161

Other practice location 1

1670 Beam Ave
Maplewood, MN 55109-1201
Phone (651) 925-8423

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

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1245323633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "9-470 MOOSE TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-5161",
            "fax_number": "612-626-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "9-470 MOOSE TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-5161",
            "fax_number": "612-626-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091201",
            "country_code": "US",
            "telephone_number": "651-925-8423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVAN",
        "first_name": "OANA",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.