Kendall Lewis Dammeier, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12894 Issued in MN

Practice address

21343 Archibald Road
Deerwood, MN 56444

Phone

(218) 534-3141

Fax

(218) 534-3949

NPI assigned

Jun 15, 2009

Last updated

Apr 19, 2019By 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 2

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.

• Northland Smiles Corporation PA

  • Clinic/Center
  • Deerwood, MN
  • NPI 1043567357
  NPD (past) Authorized official
• Northland Smiles Little Falls, PA

  • Dental Clinic/Center
  • Little Falls, MN
  • NPI 1063972271
  NPD (past) Authorized official
• Deerwood Dental, Inc

  dba The Smile Center

  • Clinic/Center
  • Deerwood, MN
  • NPI 1730262585
  NPD (past)
• Dental Associates of Decorah PC

  • General Practice Dentistry
  • Decorah, IA
  • NPI 1760585350
  NPD (past)

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1679700942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 385",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "56444",
            "telephone_number": "218-534-3141",
            "fax_number": "218-534-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21343 ARCHIBALD ROAD",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "56444",
            "telephone_number": "218-534-3141",
            "fax_number": "218-534-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMMEIER",
        "first_name": "KENDALL",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08634",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Branum, OTR/L
• James Edmund Call Jr., M.D.
• Anna Carr
• Central Minnesota Home Care, Inc. (Preferred Care at Home of Central Minnesota)
• Cummings Treasured Time Adult Day Center LLC
• Rachael Ann Darling
• Deerwood Dental, Inc (The Smile Center)
• Molly Rebecca Gervich, DDS
• Lakes Area Mobile Smiles, Inc (Lakes Mobile Dental)
• Jamie Don Lauwagie, MD

• Dentist in Deerwood, MN
• Providers in Deerwood, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.