Individual provider Active NPI

Jagannathan Ramakrishnan, DDS

  • General Practice Dentistry
  • Big Lake, MN
National Provider Identifier
1396897310
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12003 Issued in MN
Practice address
195 Jefferson Blvd
Big Lake, MN 55309-9572
Phone
(762) 263-2222
Fax
(763) 263-5822
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 D12003 MN Primary

Addresses

Primary practice location

195 Jefferson Blvd
Big Lake, MN 55309-9572

Mailing address

307 E 7TH St
Apt 206
Monticello, MN 55362-8046
Phone (763) 263-2222

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
I20160405001643 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133426224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Services Inc General Practice Past Accepting new patients
Modern Dental Professionals MN PC General Practice Past Accepting new patients

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, 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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396897310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E 7TH ST",
            "address_2": "APT 206",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628046",
            "telephone_number": "763-263-2222",
            "fax_number": "763-263-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 JEFFERSON BLVD",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099572",
            "telephone_number": "762-263-2222",
            "fax_number": "763-263-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAKRISHNAN",
        "first_name": "JAGANNATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Lake, MN

Sources for this page

Verify at the official NPI Registry.