Active NPI
Bienvenido Zaragoza Medrano III, DMD
- Dentist
- Mankato, MN
National Provider Identifier
1356657274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12876
- Practice address
- 309 Holly LN
Mankato, MN 56001-5422 - Phone
- (507) 388-2120
- Fax
- (507) 388-3924
- NPI assigned
- Aug 30, 2010
- 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 | D12876 | MN | Primary |
Addresses
Primary practice location
309 Holly LN
Mankato, MN 56001-5422
Mailing address
309 Holly LN
Mankato, MN 56001-5422
Phone (507) 388-2120
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12876 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356048000000",
"number": "1356657274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 HOLLY LN",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015422",
"telephone_number": "507-388-2120",
"fax_number": "507-388-3924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 HOLLY LN",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015422",
"telephone_number": "507-388-2120",
"fax_number": "507-388-3924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDRANO",
"first_name": "BIENVENIDO",
"middle_name": "ZARAGOZA",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-30",
"last_updated": "2012-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D12876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
- Bailey Ann McNulty, LICSW, MSW
- McOnnect Transportation Company LLC (Mconnect Transportation)
- Amelia Marie McQuery, RD, CDE, LD
- Med Surgical Suites PA
- Medexpress Urgent Care Minnesota PC (MedExpress Urgent Care - Mankato, Madison Ave)
- Janet Marie Meegan, MSW, LICSW
- Christopher K Meehan, DDS
- Tami Meehan, PT
- Allen M Meerbeek, CRNA
- Mary Kay Megard
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.