Individual provider Active NPI

Mark W. Bachman, D.D.S.

  • General Practice Dentistry
  • Bloomington, MN
National Provider Identifier
1326112384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11486 Issued in MN
Practice address
525 W 98TH St
Bloomington, MN 55420-4713
Phone
(952) 881-2243
Fax
(952) 888-6988
NPI assigned
Nov 20, 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
General Practice Dentistry 1223G0001X 11486 MN Primary

Addresses

Primary practice location

525 W 98TH St
Bloomington, MN 55420-4713

Mailing address

525 W 98TH St
Bloomington, MN 55420-4713
Phone (952) 881-2243

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
I20160617000363 MN Order and Referring Only - DentistPractitioner - Dentist 2769773027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11486MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oxboro Dental Care General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326112384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204713",
            "telephone_number": "952-881-2243",
            "fax_number": "952-888-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204713",
            "telephone_number": "952-881-2243",
            "fax_number": "952-888-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHMAN",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.