Brandon Lee Ulstad, DDS – Dentist in Madison, MN

Key facts

NPI: 1376587907
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 11578 (MN)
Practice address: 622 3Rd St
Madison, MN 56256
Phone: (320) 598-7433
NPI assigned: Jun 15, 2006
Sex: Male
Sole proprietor: No

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.

Madison Dental Clinic PLLC Dental Clinic/Center · Madison, MN · NPI 1568238509

NPD

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Lac Qui Parle Clinic of Madison Inc Rural Health Clinic/Center · Madison, MN · NPI 1144266156

CMS ownership CORPORATE DIRECTOR

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MN
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
Lac Qui Parle Clinic of Madison Inc Madison, MN · CCN 243990	Rural health clinic	Corporate Director	Feb 23, 2016

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20150609001171	MN	Order and Referring Only - Dentist Practitioner - Dentist	9739400284

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Madison Dental Clinic PLLC		Current since Dec 3, 2023	Accepting new patients

Locations

622 W 3rd St
Madison, MN 56256
Phone (320) 598-7433

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	11578	MN	Yes

Addresses

Primary practice location

622 3Rd St
Madison, MN 56256

Mailing address

622 3Rd St
PO Box 10
Madison, MN 56256
Phone (320) 598-7433

Other providers in Madison, MN

All providers in Madison, MN · Dentist in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.