Jude Jerome Severson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15091 Issued in MN

Practice address

1050 Minnesota Ave S
Aitkin, MN 56431-7412

Phone

(218) 927-3785

NPI assigned

Jun 6, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• River Oaks Dental

  • General Practice Dentistry
  • Aitkin, MN
  • NPI 1780920256
  NPD

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1811738420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21466 ARCHIBALD RD",
            "city": "DEERWOOD",
            "state": "MN",
            "postal_code": "564444100",
            "telephone_number": "218-821-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MINNESOTA AVE S",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564317412",
            "telephone_number": "218-927-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "JUDE",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln R Roth, CRNA
• Brooke Danielle Sander, LMFT
• Linnae Marie Schansberg, LADC
• Diane Schlagel, MSLP
• Charles P Schotzko, M.D.
• McLean Severson, D.D.S.
• Shopko Stores Operating Co LLC
• Kenneth L Siegford, MASSAGE THERAPIST
• William E Stein, DDS
• Jessica Sue Struwve, MSW

• General Practice Dentistry in Aitkin, MN
• Providers in Aitkin, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.