Individual provider Active NPI

Wendy A Tanner, DDS

  • General Practice Dentistry
  • Osseo, MN
National Provider Identifier
1437269693
Registry record updated Apr 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10153 Issued in MN
Practice address
30 Central Ave
Osseo, MN 55369-1241
Phone
(763) 425-2626
NPI assigned
Aug 30, 2006
Last updated
Apr 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10153 MN Primary

Addresses

Primary practice location

30 Central Ave
Osseo, MN 55369-1241

Mailing address

30 Central Ave
Osseo, MN 55369-1241
Phone (763) 425-2626

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171121001733 MN Practitioner - Oral Surgery 0143531020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10153MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. General Practice CurrentSince Oct 2, 2017 Accepting new patients
Osseo Family Dental, PLLC CurrentSince Apr 9, 2023 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. General Practice CurrentSince Oct 2, 2017 Accepting new patients

Locations

30 Central Ave
Osseo, MN 55369
Phone (763) 425-2626

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

1430 Highway 96 E
White Bear Lake, MN 55110
Phone (651) 426-9502

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680393600000",
    "number": "1437269693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CENTRAL AVE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691241",
            "telephone_number": "763-425-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CENTRAL AVE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691241",
            "telephone_number": "763-425-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "WENDY",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osseo, MN

Sources for this page

Verify at the official NPI Registry.