Aleksa Tataryn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15059 Issued in MN

Practice address

1632 Washington St NE
Minneapolis, MN 55413-1336

Phone

(612) 789-2853

NPI assigned

May 29, 2024

Sex

Female

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

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.

• Saint Anthony Village Dentistry

  • Dental Clinic/Center
  • St Anthony, MN
  • NPI 1528535788
  NPD (past)

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1558101246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 ROSEWOOD LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422099",
            "telephone_number": "763-350-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 WASHINGTON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131336",
            "telephone_number": "612-789-2853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 33rd Ave NE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554181539",
            "country_code": "US",
            "telephone_number": "612-789-2853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATARYN",
        "first_name": "ALEKSA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasks Unlimited Mental Health Services
• Tasks Unlimited Mental Health Services
• Tasks Unlimited Mental Health Services
• Tasks Unlimited Mental Health Services
• Cynthia Marie Tastad, OTR
• Courtney Lee Tate, RD
• Kelly Ann Tate, LICSW
• Sarah Jane Tate
• Tabitha Marie Tate
• Janet Louise Taterka, MS L.AC

• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.