NPIMap

Michael Morris Talberg, DDS

Individual provider Active NPI Dentist · Cook, MN

NPI 1740717271 · NPPES record last updated May 15, 2017

Key facts

NPI
1740717271
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
D13816 (MN)
Practice address
20 5TH St SE
Cook, MN 55723-9702
Phone
(218) 666-5958
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D13816MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Area Health Services, Inc Past Accepting new patients
Cook Area Health Services, Inc. Past Accepting new patients
Cook Area Health Services, Inc Past Accepting new patients
Cook Area Health Services, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13816 MN Yes

Addresses

Primary practice location

20 5TH St SE
Cook, MN 55723-9702

Mailing address

9104 Tewsbury Gate
Maple Grove, MN 55311-1128
Phone (763) 221-2165

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 15, 2017.

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1740717271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 TEWSBURY GATE",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111128",
            "telephone_number": "763-221-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 5TH ST SE",
            "city": "COOK",
            "state": "MN",
            "postal_code": "557239702",
            "telephone_number": "218-666-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBERG",
        "first_name": "MICHAEL",
        "middle_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cook, MN

All providers in Cook, MN · Dentist in Minnesota

Sources for this page

Verify at the official NPI Registry.