Annelise Nelson, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13605 Issued in MN

Practice address

15535 34TH Ave N Ste 250
Plymouth, MN 55447-2171

Phone

(763) 233-3310

NPI assigned

Aug 12, 2015

Sex

Female

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

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.

• PDG, PA

  • Dental Clinic/Center
  • Plymouth, MN
  • NPI 1548687296
  NPD (past)

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1831565969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15535 34TH AVE N STE 250",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554472171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15535 34TH AVE N STE 250",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554472171",
            "telephone_number": "763-233-3310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 Wayzata Blvd East Ste 303",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553914107",
            "country_code": "US",
            "telephone_number": "952-746-7891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1421 Wayzata Blvd East Ste 303",
            "address_purpose": "LOCATION",
            "city": "Wayzata",
            "state": "MN",
            "postal_code": "553914107",
            "country_code": "US",
            "telephone_number": "952-746-7891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANNELISE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dovile Nazarevych
• Gladys Ayiera Ndege, CNP
• Madeline Felice Nehotte
• Paige Renee Nelson-Ansley, PSYD, LP
• Andrea Nelson
• Janice Nelson, CRNA
• Kari J. Nelson, PSY.D., L.P.
• Kathleen Nelson, MT,BC,NMT
• Michael Nelson
• Taylor Nelson, MSN, CNP, AGNP-C

• General Practice Dentistry in Plymouth, MN
• Providers in Plymouth, 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 Apr 23, 2018; 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.