Individual provider Active NPI

Mark W Bettes, DDS

  • Prosthodontics
  • Saint Paul, MN
National Provider Identifier
1497712970
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
10425 Issued in MN
Practice address
2500 Como Ave
Healthpartners Como Dental Specialty Clinic
Saint Paul, MN 55108-1460
Phone
(952) 896-1111
Fax
(952) 253-9271
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 10425 MN Primary

Addresses

Primary practice location

2500 Como Ave
Healthpartners Como Dental Specialty Clinic
Saint Paul, MN 55108-1460

Mailing address

2500 Como Ave
Healthpartners Como Dental Specialty Clinic
Saint Paul, MN 55108-1460
Phone (651) 647-2500

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
I20140116001244 MN Practitioner - Oral Surgery 7911135058 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10425MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Prosthodontics CurrentSince Jan 1, 2014 Accepting new patients
Group Health, Inc. Prosthodontics CurrentSince Jan 1, 2014 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 3

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1497712970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "address_2": "HEALTHPARTNERS COMO DENTAL SPECIALTY CLINIC",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-647-2500",
            "fax_number": "651-632-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "address_2": "HEALTHPARTNERS COMO DENTAL SPECIALTY CLINIC",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "952-896-1111",
            "fax_number": "952-253-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTES",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "10425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.