Deborrah Jane Nordblom, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10101 Issued in MN

Practice address

14990 Glazier Ave
Apple Valley, MN 55124-7818

Phone

(952) 431-5114

Fax

(952) 431-3576

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

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.

• Northland Dental Partners, PLLC

  • General Practice Dentistry
  • Apple Valley, MN
  • NPI 1659528891
  NPD
• Katherine V. Conway D.D.S. P. a

  • General Practice Dentistry
  • Hastings, MN
  • NPI 1568569416
  NPD (past)
• PDG, P.a.

  • General Practice Dentistry
  • Apple Valley, MN
  • NPI 1841366093
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1821155573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14990 GLAZIER AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247818",
            "telephone_number": "952-431-5114",
            "fax_number": "952-431-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14990 GLAZIER AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247818",
            "telephone_number": "952-431-5114",
            "fax_number": "952-431-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDBLOM",
        "first_name": "DEBORRAH",
        "middle_name": "JANE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10101",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "000724372",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mstaupe@amdpi.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14990 Glazier Ave",
            "city": "Apple Valley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551247818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Alice Nimmo, LMFT
• Nobelcaretransport LLC
• Melissa A Nokes, MA, LMFT
• Bosteya Hassan Noor
• Tara Marie Nordberg, FNP
• Katherine Anne Nordeen, D.D.S.
• Kyle Nordeen, DDS
• Shanna Lee Nordeen, PHARM D
• Jenny Marie Nordell, MA, LPCC
• Tad Michel Norris, D.C.

• General Practice Dentistry in Apple Valley, MN
• Providers in Apple Valley, 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 Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.