Active NPI
Dewayne M Dunham, CRNA
- Certified Registered Nurse Anesthetist
- Detroit Lakes, MN
National Provider Identifier
1720029325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R094125-3
- Practice address
- 125 Frazee St E
Detroit Lakes, MN 56501-3501 - Phone
- (218) 844-2300
- Fax
- (218) 844-2444
- NPI assigned
- Jun 8, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R094125-3 | MN | Primary |
Addresses
Primary practice location
125 Frazee St E
Detroit Lakes, MN 56501-3501
Mailing address
PO Box 727
Detroit Lakes, MN 56502-0727
Phone (218) 844-2300
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3957 | Other | MN | NDBS # |
| 2000755 | Other | MN | MEDICA # |
| 56489DU | Other | ND | MNBS # |
| 12324 | Medicaid | MN | |
| 2T933DU | Other | FM | MNBS # |
| 40087 | Other | MN | MNBS # |
| HP38638 | Other | MN | HEALTHPARTNERS # |
| DA9031015530 | Other | MN | PREFERRED ONE # |
| 3579 | Other | ND | NDBS # |
| 142332 | Other | MN | UCARE # |
| ND200082 | Other | ND | LHS/BANNERHEALTH # |
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R094125-3 | MN | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1720029325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 727",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565020727",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FRAZEE ST E",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013501",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "DEWAYNE",
"middle_name": "M",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R094125-3",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "3957",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "2000755",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "56489DU",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12324",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "2T933DU",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "40087",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP38638",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9031015530",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "3579",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE #",
"identifier": "142332",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS/BANNERHEALTH #",
"identifier": "ND200082",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.