Individual provider Active NPI

Sean Patrick Laidig, D.D.S.

  • General Practice Dentistry
  • Stillwater, MN
National Provider Identifier
1811197882
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12381 Issued in MN
Practice address
855 Eagle Ridge LN
Stillwater, MN 55082-9171
Phone
(651) 439-2808
NPI assigned
Jul 19, 2007
Last updated
Jul 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 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 D12381 MN Primary

Addresses

Primary practice location

855 Eagle Ridge LN
Stillwater, MN 55082-9171

Mailing address

855 Eagle Ridge LN
Stillwater, MN 55082-9171
Phone (651) 439-2808

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D12381MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1811197882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 EAGLE RIDGE LN",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550829171",
            "telephone_number": "651-439-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 EAGLE RIDGE LN",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550829171",
            "telephone_number": "651-439-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDIG",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.