Individual provider Active NPI

Steven John Henseler

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Woodbury, MN
National Provider Identifier
1528128436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10804 Issued in MN
Practice address
1000 Radio Dr Ste 220
Woodbury, MN 55125-8444
Phone
(651) 739-1555
Fax
(651) 739-1556
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10804 MN Primary

Addresses

Primary practice location

1000 Radio Dr Ste 220
Woodbury, MN 55125-8444

Mailing address

1000 Radio Dr Ste 220
Woodbury, MN 55125-8444
Phone (651) 739-1555

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

State licenses

LicenseStateTypeSpecialty
10804MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henseler Orthodontics Orthodontics and Dentofacial Orthopedics 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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528128436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258444",
            "telephone_number": "651-739-1555",
            "fax_number": "651-739-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258444",
            "telephone_number": "651-739-1555",
            "fax_number": "651-739-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSELER",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "10804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, 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.

Verify at the official NPI Registry.