Individual provider Active NPI

Badri Jureidini, DDS, MS

  • Endodontics
  • Coon Rapids, MN
National Provider Identifier
1467419648
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D11244 Issued in MN
Practice address
11464 Robinson Dr NW
Coon Rapids, MN 55433-3745
Phone
(763) 767-6202
Fax
(763) 767-6259
NPI assigned
Apr 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D11244 MN Primary

Addresses

Primary practice location

11464 Robinson Dr NW
Coon Rapids, MN 55433-3745

Mailing address

11464 Robinson Dr NW
Coon Rapids, MN 55433-3745
Phone (763) 767-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170110001177 MD Order and Referring Only - DentistPractitioner - Dentist 7911288766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D11244MNMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Associates Limited Endodontics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467419648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11464 ROBINSON DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333745",
            "telephone_number": "763-767-6202",
            "fax_number": "763-767-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11464 ROBINSON DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333745",
            "telephone_number": "763-767-6202",
            "fax_number": "763-767-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUREIDINI",
        "first_name": "BADRI",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.