Ashley Dirksen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D105100 Issued in MN

Practice address

629 Legion Dr Ste 2
Montevideo, MN 56265-1729

Phone

(320) 269-6416

Fax

(320) 269-8136

NPI assigned

Jun 18, 2024

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Granite Falls Family Dentistry

  • General Practice Dentistry
  • Granite Falls, MN
  • NPI 1790088680
  NPD (past)

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1407699358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 LEGION DR STE 2",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651729",
            "telephone_number": "320-226-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 LEGION DR STE 2",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651729",
            "telephone_number": "320-269-6416",
            "fax_number": "320-269-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 6th St",
            "address_purpose": "LOCATION",
            "city": "Granite Falls",
            "state": "MN",
            "postal_code": "562411318",
            "country_code": "US",
            "telephone_number": "320-564-4281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIRKSEN",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D105100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheena Kay Dauer, DPT
• David Burrichter, DDS, PLLC
• Theresa Day, CCC-SLP
• Lisa Joy Decathelineau, LMFT
• Kelly Dawn Degrote, BSN, RN, PED-BC, CDC
• Lana Jane Dirksen, MD
• Discover Your Sisu Therapy Services, LLC
• Tracy Lynn Dove
• Jennifer Drogosch-Garberich, RN
• Karley Duenwald, MSW

• General Practice Dentistry in Montevideo, MN
• Providers in Montevideo, 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 Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.