Individual provider Active NPI

Joseph William Winegar, DDS

  • General Practice Dentistry
  • Blaine, MN
National Provider Identifier
1730310145
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12699 Issued in MN
Practice address
4255 Pheasant Ridge Dr NE
Blaine, MN 55449-4537
Phone
(763) 225-6100
NPI assigned
Aug 3, 2009
Last updated
Nov 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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 D12699 MN Primary

Addresses

Primary practice location

4255 Pheasant Ridge Dr NE
Blaine, MN 55449-4537

Mailing address

4255 Pheasant Ridge Dr NE
Blaine, MN 55449-4537
Phone (763) 225-6100

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
I20160302001586 MN Order and Referring Only - DentistPractitioner - Dentist 2163728072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12699MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1730310145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494537",
            "telephone_number": "763-225-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494537",
            "telephone_number": "763-225-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEGAR",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.