Colleen Ann Israelson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10501 Issued in MN

Practice address

8063 Hadley Ave S
Upper Level
Cottage Grove, MN 55016-2652

Phone

(651) 459-4894

Fax

(651) 458-4940

NPI assigned

Dec 1, 2006

Last updated

Mar 24, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1396813853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 9TH ST N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550429739",
            "telephone_number": "651-738-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8063 HADLEY AVE S",
            "address_2": "UPPER LEVEL",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550162652",
            "telephone_number": "651-459-4894",
            "fax_number": "651-458-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAELSON",
        "first_name": "COLLEEN",
        "middle_name": "ANN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydnie Hunter
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• Integrity Dental Care, P.a.
• Integrity Homecare Services, Inc (Integrity Homecare)
• Naomi Jackson
• JJS Optical LLC (Cottage Grove Optical)
• Pauline Johanik
• Gretchen E Johnsen, MD
• Dominique Johnson, RN

• General Practice Dentistry in Cottage Grove, MN
• Providers in Cottage Grove, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.