Individual provider Active NPI

Suzanne Ward Fischard, DDS

  • Dentist
  • Mendota Heights, MN
National Provider Identifier
1780932103
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D13158 Issued in MN
Practice address
720 Main St
Suite 213
Mendota Heights, MN 55118-3757
Phone
(651) 209-9219
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13158 MN Primary

Addresses

Primary practice location

720 Main St
Suite 213
Mendota Heights, MN 55118-3757

Mailing address

951 Skyline LN SW
Rochester, MN 55902-0985
Phone (612) 219-6816

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
I20160113002983 MN Order and Referring Only - DentistPractitioner - Dentist 0345542916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13158MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sawyer Dental LLC Dentist Past 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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1780932103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 SKYLINE LN SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559020985",
            "telephone_number": "612-219-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MAIN ST",
            "address_2": "SUITE 213",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551183757",
            "telephone_number": "651-209-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHARD",
        "first_name": "SUZANNE",
        "middle_name": "WARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota Heights, MN

Sources for this page

Verify at the official NPI Registry.