Andrew Vostad, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12981 Issued in MN

Practice address

104 Plainview Ave
Eagle Lake, MN 56024-7713

Phone

(507) 257-3800

NPI assigned

Apr 6, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eagle Lake Family Dental, PLLC

  • Dental Clinic/Center
  • Eagle Lake, MN
  • NPI 1114853660
  NPD (past)

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1245529650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "EAGLE LAKE",
            "state": "MN",
            "postal_code": "560240097",
            "telephone_number": "507-257-3800",
            "fax_number": "507-200-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PLAINVIEW AVE",
            "city": "EAGLE LAKE",
            "state": "MN",
            "postal_code": "560247713",
            "telephone_number": "507-257-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOSTAD",
        "first_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdulahi Osman
• Brianna Marie Prange, DNP, APRN, FNP-C
• Brandon Lane Sloniker, DC
• Southern Minn. Homecare LLC
• Southern Minnesota Home Care
• Amy Marie Williams, L.A.C
• Steven Yath, RN

• General Practice Dentistry in Eagle Lake, MN
• Providers in Eagle Lake, 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 Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.