Active NPI
Thomas Michael Dewerd, DDS
- Dentist
- Robbinsdale, MN
National Provider Identifier
1316113624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D9357
- Practice address
- 3359 W Broadway Ave
Robbinsdale, MN 55422-2928 - Phone
- (763) 522-4451
- Fax
- (763) 522-2464
- NPI assigned
- May 6, 2008
- 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 | D9357 | MN | Primary |
Addresses
Primary practice location
3359 W Broadway Ave
Robbinsdale, MN 55422-2928
Mailing address
3359 W Broadway Ave
Robbinsdale, MN 55422-2928
Phone (763) 522-4451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 982220800 | Other | MN | MHCP PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
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": "1210032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1316113624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3359 W BROADWAY AVE",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222928",
"telephone_number": "763-522-4451",
"fax_number": "763-522-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3359 W BROADWAY AVE",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222928",
"telephone_number": "763-522-4451",
"fax_number": "763-522-2464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWERD",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-06",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D9357",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHCP PROVIDER NUMBER",
"identifier": "982220800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.