Active NPI
Alejandro Cisneros, DDS
- Dentist
- Cambridge, MN
National Provider Identifier
1255997532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14169
- Practice address
- 135 Opportunity Blvd S
Cambridge, MN 55008-1238 - Phone
- (763) 689-1554
- NPI assigned
- May 13, 2019
- Last updated
- May 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D14169 | MN | Primary |
Addresses
Primary practice location
135 Opportunity Blvd S
Cambridge, MN 55008-1238
Mailing address
4515 121St Ave NE
Blaine, MN 55449-7065
Phone (714) 600-4660
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14169 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthew J Peterson, DDS, PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Cambridge Dental Center
- Dental Clinic/Center
- Cambridge, MN
- NPI 1366539082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1255997532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4515 121ST AVE NE",
"city": "BLAINE",
"state": "MN",
"postal_code": "554497065",
"telephone_number": "714-600-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 OPPORTUNITY BLVD S",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550081238",
"telephone_number": "763-689-1554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISNEROS",
"first_name": "ALEJANDRO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-13",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.