Emmanuel J Patrick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14296 Issued in MN

Practice address

1125 Silver Lake Rd NW
New Brighton, MN 55112-6324

Phone

(651) 842-8426

NPI assigned

Jul 24, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1760035141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15546 OMEGA TRL SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722033",
            "telephone_number": "952-807-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126324",
            "telephone_number": "651-842-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "EMMANUEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee James Panzer, PT
• Kim Contardi Pareigat, MA LP
• Sarah Elizabeth Parker, LMFT
• Parkside Dental, P.C.
• Thomas Pastor IV, D.C.
• Megan Patterson
• Donna M Pattie, LICSW
• Danielle Elizabeth Pattison, DC
• Pause Therapeutic Services PLLC
• Shenna Marie Payne, MA, LMFT

• General Practice Dentistry in New Brighton, MN
• Providers in New Brighton, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.