Trent John Neisen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14013 Issued in MN

Practice address

1016 1St St S
Willmar, MN 56201-3510

Phone

(320) 235-2010

NPI assigned

Apr 10, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Willmar Family Dentistry, P.a.

  • Dentist
  • Willmar, MN
  • NPI 1205204674
  NPD (past)
• Willmar Family Dentistry, PA

  • General Practice Dentistry
  • Willmar, MN
  • NPI 1376615450
  NPD (past)

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1689171282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013510",
            "telephone_number": "320-235-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013510",
            "telephone_number": "320-235-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISEN",
        "first_name": "TRENT",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14013",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10295",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund Edward Nadolny, PH.D.
• Michael A Nagel, O.D.
• Marvin Rudolph Napgezek, M.D.
• Mallory Theresa Nath, LICSW
• Steven J Nedrelow, DDS MSD PA
• Nelson Clinic and Rehabilitation Care PA
• Ann Marie Nelson, CRNA
• Barbara Jean Nelson, LMFT
• Daniel S. Nelson, MA/LPCC
• Elizabeth Nelson

• General Practice Dentistry in Willmar, MN
• Providers in Willmar, 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 Jun 19, 2023; 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.