Individual provider Active NPI

Brian Hadfield

  • Oral and Maxillofacial Surgery (Dentist)
  • Minneapolis, MN
National Provider Identifier
1639791015
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D14858 Issued in MN
Practice address
515 Delaware St SE
Minneapolis, MN 55455-0357
Phone
(612) 625-2495
NPI assigned
May 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X D14858 MN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D14858 MN Primary

Addresses

Primary practice location

515 Delaware St SE
Minneapolis, MN 55455-0357

Mailing address

515 Delaware St SE
Minneapolis, MN 55455-0357

Other practice location 1

701 Park Ave.
Department of Dentistry
Minneapolis, MN 55415
Phone (612) 837-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL minneapolis Direct

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
I20200630002538 MN Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 5597188094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14858MNMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1639791015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-625-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave.",
            "address_2": "Department of Dentistry",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-837-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADFIELD",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "D14858",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D14858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "minneapolis",
            "affiliation": "N",
            "endpointDescription": "my place of residence and employment",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 Park Ave.",
            "address_2": "Department of Dentistry",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.