Individual provider Active NPI

Marissa Kaplan, D.D.S.

  • General Practice Dentistry
  • Coon Rapids, MN
National Provider Identifier
1609279140
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13444 Issued in MN
Practice address
13040 Riverdale Dr NW Ste 600
Coon Rapids, MN 55448-8419
Phone
(763) 323-3042
NPI assigned
Sep 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D13444 MN Primary

Addresses

Primary practice location

13040 Riverdale Dr NW Ste 600
Coon Rapids, MN 55448-8419

Mailing address

13040 Riverdale Dr NW Ste 600
Coon Rapids, MN 55448-8419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161203000278 FL Order and Referring Only - DentistPractitioner - Dentist 4587966460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13444MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Dental Partners, PLLC General Practice PastSince Mar 20, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1609279140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13040 RIVERDALE DR NW STE 600",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554488419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13040 RIVERDALE DR NW STE 600",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554488419",
            "telephone_number": "763-323-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "MARISSA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.