Individual provider Active NPI

Pallavi Bhosale, DDS

  • Dentist
  • Maplewood, MN
National Provider Identifier
1295116259
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D13527 Issued in MN
Practice address
1670 Beam Ave Ste 204
Maplewood, MN 55109-1227
Phone
(763) 270-5776
NPI assigned
Jun 16, 2015
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13527 MN Primary

Addresses

Primary practice location

1670 Beam Ave Ste 204
Maplewood, MN 55109-1227

Mailing address

1159 Autumn St
Roseville, MN 55113-6102

Other names 1

  • Pallavi Pratap Bhosale Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160217000911 MN Order and Referring Only - DentistPractitioner - Dentist 2163727843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13527MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dental Care Inc CurrentSince Aug 17, 2025 Accepting new patients

Locations

1670 Beam Ave
Ste 204
Saint Paul, MN 55109
Phone (651) 925-8400

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.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1295116259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 AUTUMN ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 BEAM AVE STE 204",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091227",
            "telephone_number": "763-270-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHOSALE",
        "first_name": "PALLAVI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PALLAVI",
            "last_name": "BHOSALE",
            "middle_name": "PRATAP",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.