Jeffrey John Bertani, DDS
Individual provider Active NPI General Practice Dentistry · Carlton, MN
NPI 1427123751 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1427123751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D11906 (MN)
- Practice address
- 210 3Rd St
Carlton, MN 55718-7703 - Phone
- (218) 336-3524
- Fax
- (218) 384-9002
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11906 | MN | Yes |
Addresses
Primary practice location
210 3Rd St
Carlton, MN 55718-7703
Mailing address
2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 394-5411
Other providers in Carlton, MN
- James A Adamczak
- Erick Russell Anderson
- Callie Bassett
- Laura Lee Bodin
- Megan Lee Bodin
- Leeann Christiansen
- City of Carlton
- Community Addiction Recovery Enterprise Carlton
All providers in Carlton, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.