Paul Enberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13122 Issued in MN

Practice address

BLDG #33001, Battalion Ave.
Ft. Hood, TX 76544

Phone

(612) 310-3750

NPI assigned

Aug 20, 2012

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

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1376891515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RABERN CT APT 416",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765131958",
            "telephone_number": "612-310-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG #33001, BATTALION AVE.",
            "city": "FT. HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "612-310-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENBERG",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Andrew Elefante
• Arne Holger Eliasson II, MD
• Nathan Elliott, DDS
• Lucinda Ellis, RN
• Stephen David Ellwood, PHARM.D.
• James J. Endres, DDS
• Richard David Erff, D.O.
• Jerry Peter Eskola, RPH
• Elisabeth Espinola
• Natasha Evans, LVN

• General Practice Dentistry in Ft. Hood, TX
• Providers in Ft. Hood, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.