Active NPI
Cheyton Homan, MDT
- Dental Therapist
- Brooklyn Park, MN
National Provider Identifier
1699504399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT172
- Practice address
- 8401 W Broadway Ave
Brooklyn Park, MN 55445-2266 - Phone
- (763) 424-5313
- NPI assigned
- Jul 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DT172 | MN | Primary |
Addresses
Primary practice location
8401 W Broadway Ave
Brooklyn Park, MN 55445-2266
Mailing address
8401 W Broadway Ave
Brooklyn Park, MN 55445-2266
Phone (763) 424-5313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT172 | MN | MD | Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maple Brook Dental Center of MN LTD | Current | Accepting new patients |
Locations
8401 W Broadway Ave
Brooklyn Park, MN 55445
Phone (763) 424-5313
Organizations & group practices 1
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.
-
dba Maple Brook Dental
- Dental Clinic/Center
- Brooklyn Park, MN
- NPI 1902614167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1699504399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 W BROADWAY AVE",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554452266",
"telephone_number": "763-424-5313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 W BROADWAY AVE",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554452266",
"telephone_number": "763-424-5313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMAN",
"first_name": "CHEYTON",
"credential": "MDT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-30",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
- Robin Blythe Hohenstern, RPH
- Hokanson Chiropractic PA (Edinburgh Family Chiropractic)
- Hannah Holien, DNP, APRN, FNP-BC
- Holistic Awarness Professional Services LLC
- Jason Lauren Holt, D.O.
- Home & Heart Care Services, LLC
- Home & Heart Health Agency Corp
- Home Joy Home Care, Inc.
- Homelife Home Care
- Homeward Bound, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.