Justin Todd Ostrem, DDS

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

11722 Issued in MN

Practice address

9655 Schmidt Lake Rd Ste 200
Plymouth, MN 55442-4530

Phone

(763) 536-1272

Fax

(763) 536-1387

NPI assigned

Dec 1, 2006

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.

• Justin T. Ostrem D.D.S. PA

  • General Practice Dentistry
  • Plymouth, MN
  • NPI 1124773460
  NPD Authorized official

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1831267467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LAKE RD AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-536-1272",
            "fax_number": "763-536-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 SCHMIDT LAKE RD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424530",
            "telephone_number": "763-536-1272",
            "fax_number": "763-536-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTREM",
        "first_name": "JUSTIN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "11722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Ortiz, LAT, ATC
• Osborne Chiropractic PA
• Joseph Dale Osborne, D.C.
• Nicole Osinde
• Harold R Oster, MD
• Jeffrey Otto, PA-C
• Carolyn Ouellette, LPCC
• Daniela T Ouzounova, MD
• Kelsey Lane Overman, MD
• Kiara Owens, MA, LMFT

• General Practice Physician in Plymouth, MN
• Providers in Plymouth, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.