Active NPI
Scott Michael Danzl, DT
- Dental Therapist
- Saint Paul, MN
National Provider Identifier
1588220677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT63
- Practice address
- 393 Dunlap St N Ste 308
Saint Paul, MN 55104-4223 - Phone
- (651) 788-7045
- NPI assigned
- May 14, 2019
- 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 |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DT63 | MN | Primary |
Addresses
Primary practice location
393 Dunlap St N Ste 308
Saint Paul, MN 55104-4223
Mailing address
11901 Central Park Way Unit 2418
Maple Grove, MN 55369-2668
Phone (651) 249-1167
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
| License | State | Type | Specialty |
|---|---|---|---|
| DT63 | MN | MD | Dental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1588220677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11901 CENTRAL PARK WAY UNIT 2418",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553692668",
"telephone_number": "651-249-1167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 DUNLAP ST N STE 308",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044223",
"telephone_number": "651-788-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANZL",
"first_name": "SCOTT",
"middle_name": "MICHAEL",
"credential": "DT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-14",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT63",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.