Elisabeth L Dommer, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D12939 Issued in MN

Practice address

2701 Nicollet Ave
Minneapolis, MN 55408-1631

Phone

(612) 874-7674

Fax

(612) 874-1117

NPI assigned

Aug 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Practice roles

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.

• Barry D Gerst DDS PA

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1073662292
  NPD (past)
• Nicollet Avenue Dental, PLLC

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1538593843
  NPD (past)

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1407134927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081631",
            "telephone_number": "612-874-7674",
            "fax_number": "612-874-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081631",
            "telephone_number": "612-874-7674",
            "fax_number": "612-874-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMMER",
        "first_name": "ELISABETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12939",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6683-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domestic Abuse Project
• Evidio Domingo Musibay, MD
• Kristine Domingo
• Joselyn Dominguez
• Danelle M Dommer, D.P.T.
• Ellen K. Dona, PSY.D., LP
• Haley Louise Donadeo
• Christopher Donahue, PHD, LP
• Erin Ann Donahue, OT
• Allen Jane Bulay Donaire, R 168150-9

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.