Individual provider Active NPI

Gary Hildebrandt, D.D.S.,M.S.

  • General Practice Dentistry
  • Golden Valley, MN
National Provider Identifier
1790854891
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11083 Issued in MN
Practice address
7501 Golden Valley Rd
Golden Valley, MN 55427-4563
Phone
(763) 544-2213
Fax
(763) 541-1758
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11083 MN Primary

Addresses

Primary practice location

7501 Golden Valley Rd
Golden Valley, MN 55427-4563

Mailing address

920 Feltl CT
Apt. #251
Hopkins, MN 55343-6100
Phone (612) 625-5130

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
I20151231001514 MN Order and Referring Only - DentistPractitioner - Dentist 4789986126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11083MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Partners of Minnesota, LTD PastSince Dec 10, 2020 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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790854891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 FELTL CT",
            "address_2": "APT. #251",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553436100",
            "telephone_number": "612-625-5130",
            "fax_number": "612-625-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274563",
            "telephone_number": "763-544-2213",
            "fax_number": "763-541-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.