Individual provider Active NPI

Thomas Andrew Karn, DMD, MS

  • Endodontics
  • Plymouth, MN
National Provider Identifier
1578638946
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D11880 Issued in MN
Practice address
3401 Highway 169 N
Plymouth, MN 55441-2413
Phone
(763) 559-0859
Fax
(763) 559-4356
NPI assigned
Nov 21, 2006
Last updated
Dec 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D11880 MN Primary

Addresses

Primary practice location

3401 Highway 169 N
Plymouth, MN 55441-2413

Mailing address

622 Roosevelt Rd 180
Saint Cloud, MN 56301-6361
Phone (320) 259-5078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001405 MN Order and Referring Only - DentistPractitioner - Dentist 5890096051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1578638946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 ROOSEVELT RD 180",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016361",
            "telephone_number": "320-259-5078",
            "fax_number": "320-259-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 HIGHWAY 169 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412413",
            "telephone_number": "763-559-0859",
            "fax_number": "763-559-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARN",
        "first_name": "THOMAS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.