Zachary Reierson, DDS – General Practice Dentistry

Key facts

NPI: 1780201129
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: D14388 (MN)
Practice address: 163 Highway 23 NE Ste 1
Spicer, MN 56288-9735
Phone: (320) 796-2158
NPI assigned: Jul 1, 2020
Sex: Male
Sole proprietor: No

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.

Kirby M. Johnson, D.D.S., LLC General Practice Dentistry · Spicer, MN · NPI 1841686359

NPD GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
D14388	MN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Kirby M. Johnson, D.D.S., LLC	General Practice	Current since Feb 8, 2023	Accepting new patients

Locations

163 Highway 23 NE
Ste 1
Spicer, MN 56288
Phone (320) 796-2158

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	D14388	MN	Yes

Addresses

Primary practice location

163 Highway 23 NE Ste 1
Spicer, MN 56288-9735

Mailing address

163 Highway 23 NE Ste 1
Spicer, MN 56288-9735

Other providers in Spicer, MN

All providers in Spicer, 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 1, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.