Active NPI
Michelle L Meiser, DDS
- Pediatric Dentistry
- Coon Rapids, MN
National Provider Identifier
1700816634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D11584
- Practice address
- 3585 124TH Ave NW
Ste 400
Coon Rapids, MN 55433-1006 - Phone
- (763) 767-1524
- Fax
- (763) 767-1528
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D11584 | MN | Primary |
Addresses
Primary practice location
3585 124TH Ave NW
Ste 400
Coon Rapids, MN 55433-1006
Mailing address
3585 124TH Ave NW
Ste 400
Coon Rapids, MN 55433-1006
Phone (763) 767-1524
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1511674 | Other | MN | UNITED CONCORDIA |
| 836963100 | Other | MN | MA |
| 98G31ME | Other | MN | BLUE CROSS |
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 |
|---|---|---|---|
| D11584 | MN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverdale Pediatric Dentistry P.a. | Pediatric Dentistry | Past | Accepting new patients |
| Riverdale Kidds Pediatric Dentistry, PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Coon Rapids, MN
- NPI 1477025906
-
- Pediatric Dentistry
- Coon Rapids, MN
- NPI 1053690198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313625600000",
"number": "1700816634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3585 124TH AVE NW",
"address_2": "STE 400",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554331006",
"telephone_number": "763-767-1524",
"fax_number": "763-767-1528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3585 124TH AVE NW",
"address_2": "STE 400",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554331006",
"telephone_number": "763-767-1524",
"fax_number": "763-767-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEISER",
"first_name": "MICHELLE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2011-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MN",
"license": "D11584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1511674",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA",
"identifier": "836963100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "98G31ME",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.