Individual provider Active NPI

George Parisis

  • Dentist
  • Richfield, MN
National Provider Identifier
1770312563
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15149 Issued in MN
Practice address
6411 Richfield Pkwy
Richfield, MN 55423-6400
Phone
(612) 869-3440
NPI assigned
Jul 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15149 MN Primary

Addresses

Primary practice location

6411 Richfield Pkwy
Richfield, MN 55423-6400

Mailing address

6411 Richfield Pkwy
Richfield, MN 55423-6400

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250811001207 MN Order and Referring Only - DentistPractitioner - Dentist 4981102886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Dentistry PC PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1770312563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 RICHFIELD PKWY",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554236400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 RICHFIELD PKWY",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554236400",
            "telephone_number": "612-869-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISIS",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.