Bryan S Michalowicz, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10028 Issued in MN

Practice address

2500 Como Avenue
St. Paul, MN 55108-1460

Phone

(651) 429-2299

Fax

(651) 429-6630

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1306909023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 COMO AVENUE",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-647-2500",
            "fax_number": "651-632-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVENUE",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-429-2299",
            "fax_number": "651-429-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALOWICZ",
        "first_name": "BRYAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "10028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Rebekah Michael, RN, BSN, PHN
• Amanda Michaelson, PHARMD
• Alyssa Michaletz
• Benjamin Michalicek, OD
• Michael Gregory Michalik, MD
• James Michaud
• Lavonne L Michaud, MD
• Michelle Krypel Psychotherapy LLC
• Ryan Duane Michels, PHARM.D.
• Michelle Mick

• Periodontics in St. Paul, MN
• Providers in St. Paul, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.