Individual provider Active NPI

Nathan Carl Porath, DDS

  • General Practice Dentistry
  • Faribault, MN
National Provider Identifier
1487965729
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12828 Issued in MN
Practice address
412 Heritage PL
Faribault, MN 55021-5248
Phone
(507) 334-7595
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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 D12828 MN Primary

Addresses

Primary practice location

412 Heritage PL
Faribault, MN 55021-5248

Mailing address

412 Heritage PL
Faribault, MN 55021-5248
Phone (507) 334-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20161128000737 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214216746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Dental Professionals, Minnesota PC Past Accepting new patients
Nomeland Dental LLC Past Accepting new patients

Organizations & group practices 2

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1487965729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215248",
            "telephone_number": "507-334-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215248",
            "telephone_number": "507-334-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORATH",
        "first_name": "NATHAN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.