Ivan P Streif, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10207 Issued in MN

Practice address

13998 Maple Knoll Way
Maple Grove, MN 55369-7004

Phone

(763) 420-3537

Fax

(763) 420-3173

NPI assigned

Jul 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457374779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13998 MAPLE KNOLL WAY",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697004",
            "telephone_number": "763-420-3537",
            "fax_number": "763-420-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13998 MAPLE KNOLL WAY",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697004",
            "telephone_number": "763-420-3537",
            "fax_number": "763-420-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREIF",
        "first_name": "IVAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "10207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Stocke, RN
• Jennifer Stoffers, CNM
• Ericka Stone, M.D.
• Toni Stone, LMFT
• Margot Elaine Storti-Marron, LICSW
• Steven Clifford Strickland, MA
• Lindsey Marie Strom, OTD, OTR/L
• Tiffany Sandra Linda Stroman
• Stuck Holdings, Inc. (Home Instead #230)
• Suite Living Senior Care of Maple Grove

• Periodontics in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.