Individual provider Active NPI

Dennis P. Vaillant, DDS

  • General Practice Dentistry
  • Red Wing, MN
National Provider Identifier
1528063419
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7024 Issued in MN
Practice address
421 W 4TH St
Red Wing, MN 55066-2555
Phone
(651) 388-6709
Fax
(651) 388-3187
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 7024 MN Primary

Addresses

Primary practice location

421 W 4TH St
Red Wing, MN 55066-2555

Mailing address

4336 Lookout LN
Red Wing, MN 55066-1512
Phone (651) 388-7239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7024MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vaillant Dental Services, LLC General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528063419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 LOOKOUT LN",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550661512",
            "telephone_number": "651-388-7239",
            "fax_number": "651-388-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 4TH ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662555",
            "telephone_number": "651-388-6709",
            "fax_number": "651-388-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANT",
        "first_name": "DENNIS",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

Verify at the official NPI Registry.