Kyle Nordeen, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D13494 Issued in MN

Practice address

15160 Foliage Ave Ste 110
Apple Valley, MN 55124-5916

Phone

(952) 715-6177

NPI assigned

Jun 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Carousel Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Apple Valley, MN
  • NPI 1114514205
  NPD Authorized official

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1538470711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 BIRCHPOND RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224900",
            "telephone_number": "952-250-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15160 FOLIAGE AVE STE 110",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245916",
            "telephone_number": "952-715-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDEEN",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D13494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa A Nokes, MA, LMFT
• Bosteya Hassan Noor
• Tara Marie Nordberg, FNP
• Deborrah Jane Nordblom, D.D.S.
• Katherine Anne Nordeen, D.D.S.
• Shanna Lee Nordeen, PHARM D
• Jenny Marie Nordell, MA, LPCC
• Tad Michel Norris, D.C.
• North Star Balance LLC
• Northland Dental Partners, PLLC

• Pediatric Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Pediatric Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.