Michael Thomas Flynn, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8759 Issued in MN

Practice address

560 Debra Dr
Lewiston, MN 55952-2104

Phone

(507) 523-2267

Fax

(507) 523-2206

NPI assigned

Sep 28, 2006

Last updated

Oct 6, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Modern Dental Professionals, MN PC

  dba Midwest Dental

  • Dentist
  • Lewiston, MN
  • NPI 1073796744
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1629169909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27249 RUSLYNN DR",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874971",
            "telephone_number": "507-452-9035",
            "fax_number": "507-457-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 DEBRA DR",
            "city": "LEWISTON",
            "state": "MN",
            "postal_code": "559522104",
            "telephone_number": "507-523-2267",
            "fax_number": "507-523-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063218000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Lewiston
• Deloughery Home Limited Partnership (Lewiston Villa Nursing Home)
• Carrie Lee Elliott-Plank, RN
• Mickel Frisch
• Lewiston Dental Care
• Modern Dental Professionals, MN PC (Midwest Dental)
• Rebecca Scharmer, CCC-SLP
• Winona County Ind School Dist 857

• General Practice Dentistry in Lewiston, MN
• Providers in Lewiston, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.