Individual provider Active NPI

Todd James Billington, D.D.S.

  • Dentist
  • Maplewood, MN
National Provider Identifier
1720460645
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60571135 Issued in WA
Practice address
2165 White Bear Ave N
Maplewood, MN 55109-2707
Phone
(516) 523-9900
NPI assigned
Jun 27, 2015
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60571135 WA Primary

Addresses

Primary practice location

2165 White Bear Ave N
Maplewood, MN 55109-2707

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (952) 883-5155

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
I20210215000305 MN Practitioner - Dentist 2567778988 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60571135WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Dentist CurrentSince Jan 18, 2021 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. Dentist CurrentSince Jan 18, 2021 Accepting new patients
Community Dental Care Inc PastSince Mar 6, 2022 Accepting new patients

Locations

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1720460645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092707",
            "telephone_number": "516-523-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLINGTON",
        "first_name": "TODD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-27",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60571135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.