Individual provider Active NPI

Sheila C Thorstenson, D.D.S.

  • Dentist
  • Minneapolis, MN
National Provider Identifier
1366496200
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11751 Issued in MN
Practice address
1315 E 24TH St
Minneapolis, MN 55404-3975
Phone
(612) 721-9800
Fax
(612) 721-2904
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11751 MN Primary

Addresses

Primary practice location

1315 E 24TH St
Minneapolis, MN 55404-3975

Mailing address

1315 E 24TH St
Minneapolis, MN 55404-3975
Phone (612) 721-9800

Other identifiers 1

IdentifierTypeStateIssuer
358634100MedicaidMN

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
I20200227002070 MN Practitioner - Dentist 1759718919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Board of Minneapolis Dentist CurrentSince Jan 11, 2020 Accepting new patients

Locations

1315 E 24th St
Minneapolis, MN 55404
Phone (612) 721-9800

2020 Minnehaha Ave
Minneapolis, MN 55404
Phone (612) 721-9800

Interoperability endpoints

  • Direct secure messaging: sthorstenson670398@direct.ochin.org

Organizations & group practices 2

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1366496200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043975",
            "telephone_number": "612-721-9800",
            "fax_number": "612-721-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043975",
            "telephone_number": "612-721-9800",
            "fax_number": "612-721-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSTENSON",
        "first_name": "SHEILA",
        "middle_name": "C",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358634100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.