Active NPI
John Nicholas Giebenhain Jr., D.D.S.
- General Practice Dentistry
- Golden Valley, MN
National Provider Identifier
1619142197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8827
- Practice address
- 5851 Duluth St
Suite 103
Golden Valley, MN 55422-3946 - Phone
- (763) 454-0330
- Fax
- (763) 277-2096
- NPI assigned
- Apr 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8827 | MN | Primary |
Addresses
Primary practice location
5851 Duluth St
Suite 103
Golden Valley, MN 55422-3946
Mailing address
5851 Duluth St
Suite 103
Golden Valley, MN 55422-3946
Phone (763) 454-0330
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8827 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creekside Family Dental PLLC | Past | Accepting new patients | |
| Giebenhain Dental Associates PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Golden Valley, MN
- NPI 1619938057
-
- Dentist
- Golden Valley, MN
- NPI 1366928426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209081600000",
"number": "1619142197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5851 DULUTH ST",
"address_2": "SUITE 103",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554223946",
"telephone_number": "763-454-0330",
"fax_number": "763-277-2096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5851 DULUTH ST",
"address_2": "SUITE 103",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554223946",
"telephone_number": "763-454-0330",
"fax_number": "763-277-2096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIEBENHAIN",
"first_name": "JOHN",
"middle_name": "NICHOLAS",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-25",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "8827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.