Mark Ivan Malterud, D.D.S.,M.A.G.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9454 Issued in MN

Practice address

770 Mount Curve Blvd
Saint Paul, MN 55116-1165

Phone

(651) 699-2822

Fax

(651) 699-3009

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Mark I. Malterud, D.D.S., P.a.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1841317732
  NPD (past) Authorized official

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679691273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MOUNT CURVE BLVD.",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551161120",
            "telephone_number": "651-699-2822",
            "fax_number": "651-699-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MOUNT CURVE BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161165",
            "telephone_number": "651-699-2822",
            "fax_number": "651-699-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTERUD",
        "first_name": "MARK",
        "middle_name": "IVAN",
        "credential": "D.D.S.,M.A.G.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savita Mall, M.D.
• Carlo Joaquin Abrina Mallari, DPT
• Laurie Malm-Gerhardson
• Ian-James Malm, M.D.
• Loni Malone, MA LPCC LADC
• Rachel Malterud, DMD
• Mark Mammel, MD
• Yosef Assefa Mamo
• David Gerard Mancini, D.C.
• Julie Manco, NP

• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.