Individual provider Active NPI

Juliana Mirodone, D.M.D.

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1396700787
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12013 Issued in MN
Practice address
1406 W Lake St
Suite 100
Minneapolis, MN 55408-2653
Phone
(612) 827-3736
Fax
(612) 821-9626
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12013 MN Primary

Addresses

Primary practice location

1406 W Lake St
Suite 100
Minneapolis, MN 55408-2653

Mailing address

1406 W Lake St
Suite 100
Minneapolis, MN 55408-2653
Phone (612) 827-3736

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
I20160106001874 MN Order and Referring Only - DentistPractitioner - Dentist 6800198995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Dental Acquisition Company General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396700787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 W LAKE ST",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082653",
            "telephone_number": "612-827-3736",
            "fax_number": "612-821-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 W LAKE ST",
            "address_2": "SUITE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082653",
            "telephone_number": "612-827-3736",
            "fax_number": "612-821-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRODONE",
        "first_name": "JULIANA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.