Thomas Joseph Schoen, DDS
Individual provider Active NPI General Practice Dentistry · Wabasha, MN
NPI 1487643136 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1487643136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9378 (MN)
- Practice address
- 257 Main St W
Wabasha, MN 55981-1238 - Phone
- (651) 565-4647
- Fax
- (651) 565-2899
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150603001416 | MN | Order and Referring Only - Other (Non-Physician) | 5799006755 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9378 | MN | MD | Doula |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T.J. Schoen Family Dentistry | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9378 | MN | Yes |
Addresses
Primary practice location
257 Main St W
Wabasha, MN 55981-1238
Mailing address
257 Main St W
PO Box 128
Wabasha, MN 55981-1238
Phone (651) 565-4647
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 772320200 | Medicaid | MN | |
| 9378 | Other | MN | DENTIST LICENSE |
Other providers in Wabasha, MN
- Saint Elizabeths Hospital of Wabasha Inc
- Saint Elizabeths Hospital of Wabasha Inc
- Mark Sandefur
- Amy Marie Sapola
- Nathaniel Thomas Schoen
- Phillip P. Schwend
- Garrett W Shanks
- Jessin Lynn Skoug
- Sarah Sylla
- T.J. Schoen Family Dentistry
All providers in Wabasha, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.