Sarah J Magnuson, DDS

Individual provider Active NPI General Practice Dentistry · Greenfield, MN

NPI 1457510596 · NPPES record last updated Nov 12, 2015

Key facts

NPI
1457510596
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D12538 (MN)
Practice address
7500 State Highway 55
Suite 200
Greenfield, MN 55373-6620
Phone
(763) 575-8038
Fax
(763) 575-8039
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151116001792 MN Order and Referring Only - Dentist
Practitioner - Dentist
2264742568

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Sarah Dental PLLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12538 MN Yes

Addresses

Primary practice location

7500 State Highway 55
Suite 200
Greenfield, MN 55373-6620

Mailing address

7500 State Highway 55
Suite 200
Greenfield, MN 55373-6620
Phone (763) 575-8038

Other names

  • Dr. Sarah J Jorgenson Former name

Other providers in Greenfield, MN

All providers in Greenfield, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.