Active NPI
Rodney A Stensrud, DDS
- Dentist
- Forest Lake, MN
National Provider Identifier
1508925637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8907
- Practice address
- 956 West Broadway
Lakes Dental Clinic
Forest Lake, MN 55025 - Phone
- (651) 464-7277
- Fax
- (651) 464-6857
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8907 | MN | Primary |
Addresses
Primary practice location
956 West Broadway
Lakes Dental Clinic
Forest Lake, MN 55025
Mailing address
PO Box 278
Lakes Dental Clinic
Forest Lake, MN 55025
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakes Dental Assoc PA | Dentist | 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.
-
- Dentist
- Forest Lake, MN
- NPI 1255490389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508925637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"address_2": "LAKES DENTAL CLINIC",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "55025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "956 WEST BROADWAY",
"address_2": "LAKES DENTAL CLINIC",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "55025",
"telephone_number": "651-464-7277",
"fax_number": "651-464-6857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STENSRUD",
"first_name": "RODNEY",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "8907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.