Individual provider Active NPI

Jayce Apelgren, D.D.S.

  • Dentist
  • Eagan, MN
National Provider Identifier
1619358397
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1001134 - 15 Issued in WI
Practice address
3938 Cedar Grove Pkwy
Eagan, MN 55122-1403
Phone
(651) 452-9660
NPI assigned
Jun 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D13938 MN
Dentist 122300000X 1001134 - 15 WI Primary

Addresses

Primary practice location

3938 Cedar Grove Pkwy
Eagan, MN 55122-1403

Mailing address

4710 Commerce Valley Rd
Eau Claire, WI 54701-9033
Phone (715) 835-0606

Other practice location 1

3922 W 50th St
Edina, MN 55424-1255
Phone (952) 026-0284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208000348 WI Order and Referring Only - Other (Non-Physician) 4789988080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001134 - 15WIMDDentist
D13938MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Apelgren Dental Dentist Past Accepting new patients
Quinn Dental P.a. 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.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1619358397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 COMMERCE VALLEY RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547019033",
            "telephone_number": "715-835-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 CEDAR GROVE PKWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221403",
            "telephone_number": "651-452-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3922 W 50th St",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554241255",
            "country_code": "US",
            "telephone_number": "952-026-0284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "APELGREN",
        "first_name": "JAYCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13938",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001134 - 15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.