Michael Joel Determan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13526 Issued in MN

Practice address

510 Marquette Ave Ste 100
Minneapolis, MN 55402-1144

Phone

(612) 338-5557

NPI assigned

Jun 14, 2015

Last updated

Jun 14, 2015By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scott C. Osborn D.D.S. and Associates PA

  dba Nicollet Station Dental

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1689741787
  NPD (past)

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434240000000",
    "number": "1346621521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MARQUETTE AVE STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554021144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MARQUETTE AVE STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554021144",
            "telephone_number": "612-338-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERMAN",
        "first_name": "MICHAEL",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2015-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanne Desmond, LICSW
• Birhanu Afsaw Desta
• Nahom Tesfaye Desta
• Destination Mobile Labs
• Lindsey Determan, LICSW
• Linda Rae Deters, PSY.D., L.P.
• Danielle Detloff, RBT
• Evelynmae Minna Detomaso
• Elizabeth E Dettling, SLP
• Cole Kiely Deutz, MD

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2015; 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.

Verify at the official NPI Registry.