Individual provider Active NPI

William L Laspe, D.D.S.

  • General Practice Dentistry
  • Plymouth, MN
National Provider Identifier
1477545135
Registry record updated Jan 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6134 Issued in OR
Practice address
15650 36TH Ave N
Plymouth, MN 55446-2560
Phone
(763) 557-0287
Fax
(763) 557-0295
NPI assigned
Aug 18, 2005
Reactivated
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2020

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 D6134 OR Primary

Addresses

Primary practice location

15650 36TH Ave N
Plymouth, MN 55446-2560

Mailing address

3895 35TH St SE
Delano, MN 55328-5200
Phone (541) 784-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6134ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578182400000",
    "number": "1477545135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 35TH ST SE",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553285200",
            "telephone_number": "541-784-5111",
            "fax_number": "763-557-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 36TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554462560",
            "telephone_number": "763-557-0287",
            "fax_number": "763-557-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASPE",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.