Andrew Christensen, D.D.S.
Individual provider Active NPI General Practice Dentistry · Wabasha, MN
NPI 1760611545 · NPPES record last updated Jul 14, 2009
Key facts
- NPI
- 1760611545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D12718 (MN)
- Practice address
- 115 Main St E
Wabasha, MN 55981-1420 - Phone
- (651) 565-3511
- NPI assigned
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151229000638 | MN | Order and Referring Only - Other (Non-Physician) | 7315248853 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D12718 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert J. Mann | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D12718 | MN | Yes |
Addresses
Primary practice location
115 Main St E
Wabasha, MN 55981-1420
Mailing address
115 Main St E
Wabasha, MN 55981-1420
Phone (651) 565-3511
Other providers in Wabasha, MN
- Grace Bouquet Boyle
- Amanda Lynne Brees
- Remington James Brisbois
- Susan J. Buck
- Brianna Byam
- City of Wabasha
- Cosan Leighis LLC
- County of Wabasha
- Crossroads Behavioral Health, P.L.C.
- Jeffrey Darling
All providers in Wabasha, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.