Individual provider Active NPI

Damian Alexander Winkelmann, DDS

  • Dentist
  • Maplewood, MN
National Provider Identifier
1609566942
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14922 Issued in MN
Practice address
2165 White Bear Ave N
Maplewood, MN 55109-2707
Phone
(651) 523-9900
NPI assigned
May 10, 2023
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14922 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2165 White Bear Ave N
Maplewood, MN 55109-2707

Mailing address

240 Chicago Ave Apt 523
Minneapolis, MN 55415-2241
Phone (763) 300-0054

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
I20240924002157 MN Practitioner - Dentist 9638610181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14922MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jul 13, 2024 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. Dentist CurrentSince Jul 13, 2024 Accepting new patients

Locations

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 3

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1609566942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CHICAGO AVE APT 523",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554152241",
            "telephone_number": "763-300-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092707",
            "telephone_number": "651-523-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKELMANN",
        "first_name": "DAMIAN",
        "middle_name": "ALEXANDER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14922",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.