Active NPI
Alexander Jerome Litzenberg, DMD
- General Practice Dentistry
- Roseville, MN
National Provider Identifier
1821526849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D13856
- Practice address
- 1835 County Road C W Ste 220
Roseville, MN 55113-1343 - Phone
- (651) 636-2123
- NPI assigned
- Jun 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D13856 | MN | Primary |
Addresses
Primary practice location
1835 County Road C W Ste 220
Roseville, MN 55113-1343
Mailing address
11901 Central Park Way Unit 2313
Maple Grove, MN 55369-2663
Phone (971) 258-8171
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
| License | State | Type | Specialty |
|---|---|---|---|
| D13856 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496448000000",
"number": "1821526849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11901 CENTRAL PARK WAY UNIT 2313",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553692663",
"telephone_number": "971-258-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 COUNTY ROAD C W STE 220",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131343",
"telephone_number": "651-636-2123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LITZENBERG",
"first_name": "ALEXANDER",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-03",
"last_updated": "2017-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D13856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.