Active NPI
Thomas Ford Everett, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Burnsville, MN
National Provider Identifier
1730217191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S15
- Practice address
- Family Orthodontic Specialists
14344 Burnhaven Dr
Burnsville, MN 55306-5306 - Phone
- (952) 435-6213
- NPI assigned
- Feb 28, 2007
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | S15 | MN | Primary |
Addresses
Primary practice location
Family Orthodontic Specialists
14344 Burnhaven Dr
Burnsville, MN 55306-5306
Mailing address
Family Orthodontics Specialists
6601 Lyndale Ave S #220
Richfield, MN 55423-5423
Phone (612) 861-9141
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160113002435 | MN | Order and Referring Only - Dentist | 8022310689 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S15 | MN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eversmiles, PLLC | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
| Bites Orthodontics PLLC | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
| Eversmiles, PLLC | Orthodontics and Dentofacial Orthopedics | Current | Accepting new patients |
Locations
901 Church St
Evanston, IL 60201
Phone (224) 904-1380
Organizations & group practices 3
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Northbrook, IL
- NPI 1548076862
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Evanston, IL
- NPI 1861377723
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Northbrook, IL
- NPI 1558243485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730217191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FAMILY ORTHODONTICS SPECIALISTS",
"address_2": "6601 LYNDALE AVE S #220",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554235423",
"telephone_number": "612-861-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FAMILY ORTHODONTIC SPECIALISTS",
"address_2": "14344 BURNHAVEN DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553065306",
"telephone_number": "952-435-6213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERETT",
"first_name": "THOMAS",
"middle_name": "FORD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MN",
"license": "S15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.