Individual provider Active NPI

Julio Heller, DDS

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1720001530
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11202 Issued in WI
Practice address
1371 7TH St W
Saint Paul, MN 55102-4205
Phone
(651) 222-0351
Fax
(651) 222-1556
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11202 WI Primary

Addresses

Primary practice location

1371 7TH St W
Saint Paul, MN 55102-4205

Mailing address

1371 7TH St W
Saint Paul, MN 55102-4205
Phone (651) 222-0351

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150708002045 MN Order and Referring Only - DentistPractitioner - Dentist 4880906502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11202WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Dentists General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720001530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024205",
            "telephone_number": "651-222-0351",
            "fax_number": "651-222-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024205",
            "telephone_number": "651-222-0351",
            "fax_number": "651-222-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "JULIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "D11202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.