Individual provider Active NPI

Andrew Joseph Vanerp

  • General Practice Dentistry
  • Maple Grove, MN
National Provider Identifier
1417700949
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D15096 Issued in MN
Practice address
13340 Bass Lake Rd
Maple Grove, MN 55311-4540
Phone
(763) 478-9219
NPI assigned
Apr 5, 2024
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13826 NC
General Practice Dentistry 1223G0001X D15096 MN Primary

Addresses

Primary practice location

13340 Bass Lake Rd
Maple Grove, MN 55311-4540

Mailing address

36907 S Silver Lake Rd
Battle Lake, MN 56515-9108
Phone (281) 640-7130

Other practice location 1

2520 Delaney Ave
Wilmington, NC 28403-6002
Phone (910) 762-1772 ext. 21772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D15096MNMDGeneral Practice Dentistry
13826NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Dental Partners, PLLC General Practice CurrentSince Oct 12, 2025 Accepting new patients

Locations

13340 Bass Lake Rd
Maple Grove, MN 55311
Phone (763) 478-9219

Organizations & group practices 1

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": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1417700949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36907 S SILVER LAKE RD",
            "city": "BATTLE LAKE",
            "state": "MN",
            "postal_code": "565159108",
            "telephone_number": "281-640-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13340 BASS LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114540",
            "telephone_number": "763-478-9219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 Delaney Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036002",
            "country_code": "US",
            "telephone_number": "910-762-1772 x21772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANERP",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-05",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13826",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.