Charyl Renee Weingarten, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12862 Issued in MN

Practice address

591 Apollo Dr
Lino Lakes, MN 55014-3005

Phone

(651) 786-7630

NPI assigned

Aug 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

State licenses

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.

• Lake Dental PLLC

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1518132117
  NPD (past)
• Red Velvet Dental LLC

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1699635870
  NPD (past)

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1285948125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 APOLLO DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550143005",
            "telephone_number": "651-786-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 APOLLO DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550143005",
            "telephone_number": "651-786-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINGARTEN",
        "first_name": "CHARYL",
        "middle_name": "RENEE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6864",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Jean Tolzmann
• Michael Charles Tressler, M.D
• Tonya Lee Van Ee, RN
• Dale Herbert Vancil, D. P, M.
• Matthew Watnemo, LPCC
• Kaylen Whetstone, CCC-SLP
• Katia J Wilcox
• Loren Max Wilkes, MD
• Sarah Elizabeth Williams, M.A. CCC-SLP
• Fred Anthony Zappa III

• General Practice Dentistry in Lino Lakes, MN
• Providers in Lino Lakes, 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 Mar 12, 2020; 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.