Active NPI
Dana John Isaacson, D.D.S.
- General Practice Dentistry
- Bloomington, MN
National Provider Identifier
1558433748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7977
- Practice address
- 4200 W Old Shakopee Rd
Suite 223
Bloomington, MN 55437-2976 - Phone
- (952) 881-8404
- Fax
- (952) 881-9520
- NPI assigned
- Nov 14, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7977 | MN | Primary |
Addresses
Primary practice location
4200 W Old Shakopee Rd
Suite 223
Bloomington, MN 55437-2976
Mailing address
4200 W Old Shakopee Rd
Suite 223
Bloomington, MN 55437-2976
Phone (952) 881-8404
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7977 | MN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558433748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 W OLD SHAKOPEE RD",
"address_2": "SUITE 223",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554372976",
"telephone_number": "952-881-8404",
"fax_number": "952-881-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 W OLD SHAKOPEE RD",
"address_2": "SUITE 223",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554372976",
"telephone_number": "952-881-8404",
"fax_number": "952-881-9520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAACSON",
"first_name": "DANA",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "7977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
- Intelligent Design Wellness PLLC
- Internal Expressions in Psychology, LLC
- International Maternal Care Initiative
- Ikram Mohammad Irfanullah, MD
- Isaacson Dental Center PLLC
- Timothy John Isaacson, D.D.S.
- Isaiah Residential Care Services LLC (Isaiah Residential Care Services)
- Dorothee M Ischler, DMFT, LMFT
- Viktoriya A. Ishchuk, DDS
- Naseeb Mohammed Ismaiel
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.