Fouad Badr, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

R553 Issued in MN

Practice address

3130 Cleveland Ave N
Arden Hills, MN 55112

Phone

(612) 624-6644

Fax

(612) 626-2655

NPI assigned

May 15, 2013

Reactivated

Dec 15, 2015

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Trinity Dental PLLC

  • General Practice Dentistry
  • Edina, MN
  • NPI 1902746951
  NPD Authorized official

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1780020966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 CLEVELAND AVE N",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-624-6644",
            "fax_number": "612-626-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 CLEVELAND AVE N",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-624-6644",
            "fax_number": "612-626-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADR",
        "first_name": "FOUAD",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2019-10-28",
        "deactivation_date": "2014-03-31",
        "reactivation_date": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "R553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole M Arndt-Wenger, LICSW
• Lareesha Arnold
• Muno Ashiro
• Associated Speech and Language
• Lauryn Kay Bacon
• Chilton Robert Baker Jr., M.D.
• David Baker
• Lauren B Baker, MD
• Balance for Life Fitness Center, Inc
• Wendy Claire Barrie, LMFT

• Dentist in Arden Hills, MN
• Providers in Arden Hills, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.