Active NPI
Callie Jocelyn Brost, DDS
- Dentist
- Eagan, MN
National Provider Identifier
1609568963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14884
- Practice address
- 1215 Town Centre Dr Ste 150
Eagan, MN 55123-2660 - Phone
- (651) 287-3729
- NPI assigned
- May 24, 2023
- Last updated
- May 24, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D14884 | MN | Primary |
Addresses
Primary practice location
1215 Town Centre Dr Ste 150
Eagan, MN 55123-2660
Mailing address
1466 Blackhawk Lake Dr
Eagan, MN 55122-1256
Phone (651) 285-4997
Other practice location 1
17436 Kenwood Trl
Lakeville, MN 55044-9219
Phone (952) 241-5899
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 |
|---|---|---|---|
| D14884 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, P.a | Current | Accepting new patients | |
| Hunter Creek Dental, PA | Past | Accepting new patients | |
| PDG, P.a. | Past | Accepting new patients |
Locations
1215 Town Centre Dr
Ste 150
Eagan, MN 55123
Phone (651) 287-3729
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.
-
- General Practice Dentistry
- Montgomery, MN
- NPI 1124575501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1609568963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1466 BLACKHAWK LAKE DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551221256",
"telephone_number": "651-285-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 TOWN CENTRE DR STE 150",
"city": "EAGAN",
"state": "MN",
"postal_code": "551232660",
"telephone_number": "651-287-3729"
}
],
"practiceLocations": [
{
"address_1": "17436 Kenwood Trl",
"address_purpose": "LOCATION",
"city": "Lakeville",
"state": "MN",
"postal_code": "550449219",
"country_code": "US",
"telephone_number": "952-241-5899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROST",
"first_name": "CALLIE",
"middle_name": "JOCELYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-24",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.