Individual provider Active NPI

Michael Jonathon Splett, DDS

  • Dentist
  • Maplewood, MN
National Provider Identifier
1295822591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11542 Issued in MN
Practice address
1736 East Cope Ave
Maplewood, MN 55109-2610
Phone
(651) 770-3831
Fax
(651) 770-9645
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11542 MN Primary

Addresses

Primary practice location

1736 East Cope Ave
Maplewood, MN 55109-2610

Mailing address

1736 East Cope Ave
Maplewood, MN 55109-2610
Phone (651) 770-3831

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
I20160122000824 MN Order and Referring Only - DentistPractitioner - Dentist 2062715105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295822591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 EAST COPE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092610",
            "telephone_number": "651-770-3831",
            "fax_number": "651-770-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 EAST COPE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092610",
            "telephone_number": "651-770-3831",
            "fax_number": "651-770-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPLETT",
        "first_name": "MICHAEL",
        "middle_name": "JONATHON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.