F C Requa DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6155 Issued in MN

Legal business name

F C REQUA DDS PA

Practice address

400 3Rd Ave NW
Austin, MN 55912

Phone

(507) 433-1641

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Frederick C Requa, DDS

Title

Pres

Phone

(507) 433-1641

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407930415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 3RD AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "55912",
            "telephone_number": "507-433-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 3RD AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "55912",
            "telephone_number": "507-433-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F C REQUA DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REQUA",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "507-433-1641",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "6155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Engelhardt
• Steven John Engman, M.D.
• Emma Christine Evans-Peck
• Heather Lynn Evatt
• Aruna A Evenson, LGSW
• Chelsea Carol Faas
• Family Eye Care Center of Austin Inc.
• Mary Louise Fargen, PA-C
• Maria A Farmer, ARNP, MSN, ACNP-BC
• Eric B Farnberg, DO

• General Practice Dentistry in Austin, MN
• Providers in Austin, 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 Aug 22, 2020; 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.