John David Mittelsteadt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09922 Issued in MN

Practice address

4555 Erin Dr
Eagan, MN 55122-3398

Phone

(651) 681-9044

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By 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

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

State licenses

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.

• Eagan Valley Dental Center P.a.

  • Dentist
  • Eagan, MN
  • NPI 1902146335
  NPD (past) Authorized official
• Ev Dental P.a

  • Dentist
  • Burnsville, MN
  • NPI 1518407014
  Authorized official Same address or phone
• Ridges Dental

  • Dental Clinic/Center
  • Burnsville, MN
  • NPI 1336656768
  Authorized official Same address or phone

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649371063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 ERIN DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223398",
            "telephone_number": "651-681-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 ERIN DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223398",
            "telephone_number": "651-681-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELSTEADT",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "09922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minuteclinic Diagnostic of Minnesota, P.a.
• Minuteclinic Diagnostic of Minnesota, P.a.
• Minuteclinic Primary Care Minnesota PLLC
• Rayan Mirza
• Laverne Mitchell Pusey, ARNP
• William Miyoshi, OD
• MJ Counseling, LLC
• MN Health LLC
• Mngi Endoscopy LLC (SouthEast Metro Endoscopy Center)
• Omer Moalim

• General Practice Dentistry in Eagan, MN
• Providers in Eagan, 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 Jul 8, 2007; 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.