Individual provider Active NPI

Gerald Alan Sandler, D.D.S.

  • General Practice Dentistry
  • Minnetonka, MN
National Provider Identifier
1750477972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8977 Issued in MN
Practice address
1730 Plymouth Rd Ste 204
Minnetonka, MN 55305-1961
Phone
(952) 541-1135
Fax
(952) 545-1811
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8977 MN Primary

Addresses

Primary practice location

1730 Plymouth Rd Ste 204
Minnetonka, MN 55305-1961

Mailing address

225 Sumter Ave S
Golden Valley, MN 55426-1413
Phone (763) 541-9346

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151207003052 MN Order and Referring Only - Other (Non-Physician) 9234439662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8977MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750477972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 SUMTER AVE S",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261413",
            "telephone_number": "763-541-9346",
            "fax_number": "952-545-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 PLYMOUTH RD STE 204",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051961",
            "telephone_number": "952-541-1135",
            "fax_number": "952-545-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "GERALD",
        "middle_name": "ALAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.