Active NPI
Robert John Phillips, D.D.S.
- Dentist
- Edina, MN
National Provider Identifier
1306285762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13252
- Practice address
- 3922 W 50TH St
Edina, MN 55424-1255 - Phone
- (952) 926-0284
- NPI assigned
- Jun 19, 2013
- 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 | D13252 | MN | Primary |
Addresses
Primary practice location
3922 W 50TH St
Edina, MN 55424-1255
Mailing address
1805 W Lake St Unit 204
Minneapolis, MN 55408-4252
Phone (952) 926-0284
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160223002184 | MN | Order and Referring Only - Dentist | 2769787183 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13252 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1306285762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 W LAKE ST UNIT 204",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554084252",
"telephone_number": "952-926-0284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3922 W 50TH ST",
"city": "EDINA",
"state": "MN",
"postal_code": "554241255",
"telephone_number": "952-926-0284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "ROBERT",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-19",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
- Shailendri Eswar-Rao Philip, M.D.
- Daniela Phillips, MD
- Katie Phillips
- Molly Elizabeth Phillips, DNP, APRN, FNP-C
- Paul P Phillips, MD
- Phoenix Physical Therapy, Inc. (Seeds of Change Health and Wellness Center)
- Phoenix Rising LLC (The Art of Healing)
- Anna Phongymany
- Physician Systems Inc
- Physician'S Urgent Care P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.