Individual provider Active NPI

Dennis Lynn Hetland, DDS

  • General Practice Dentistry
  • Fargo, ND
National Provider Identifier
1285732313
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1783 Issued in ND
Practice address
3525 25TH Street South
Fargo, ND 58104-5900
Phone
(701) 298-9400
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2009

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 1783 ND Primary

Addresses

Primary practice location

3525 25TH Street South
Fargo, ND 58104-5900

Mailing address

3525 25TH St S
Fargo, ND 58104-5900
Phone (701) 298-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20090211000757 ND Practitioner - Oral Surgery 3072678838 Practice locations: Fargo, ND

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Remedies Sleep Solutions CurrentSince Apr 1, 2020 Accepting new patients
Jeffrey J Harrie DDS PC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1285732313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045900",
            "telephone_number": "701-298-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 25TH STREET SOUTH",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045900",
            "telephone_number": "701-298-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETLAND",
        "first_name": "DENNIS",
        "middle_name": "LYNN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.