Luke E. Waln, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D11842 Issued in MN

Practice address

25477 Main St
Nisswa Smiles
Nisswa, MN 56468-5001

Phone

(218) 963-6330

Fax

(218) 963-6332

NPI assigned

Nov 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Luke Waln Dentistry, PC

  dba Nisswa Smiles

  • Dentist
  • Nisswa, MN
  • NPI 1427680040
  NPD Authorized official
• Staples Smiles

  • Dentist
  • Staples, MN
  • NPI 1063172468
  NPD Authorized official

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1740263094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25477 MAIN ST",
            "address_2": "P.O BOX 454",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564685001",
            "telephone_number": "218-963-6330",
            "fax_number": "218-963-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25477 MAIN ST",
            "address_2": "NISSWA SMILES",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564685001",
            "telephone_number": "218-963-6330",
            "fax_number": "218-963-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALN",
        "first_name": "LUKE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aron Michael Stumvoll, DC
• Lisa Marie Swenson, RDCS
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Home Health)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society- Homec Care and Hospice)
• Mary Katherine Verkennes, M.A. L.P.
• Wellnessone of Nisswa
• Wellspring Behavioral Health

• Dentist in Nisswa, MN
• Providers in Nisswa, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.

Verify at the official NPI Registry.