Active NPI
Janna Rae Holmgren, DDS
- General Practice Dentistry
- Maple Grove, MN
National Provider Identifier
1851828214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D13814
- Practice address
- 9600 Upland LN N Ste 200
Maple Grove, MN 55369-4496 - Phone
- (763) 416-0037
- Fax
- (763) 420-5428
- NPI assigned
- May 16, 2017
- Last updated
- May 16, 2017
- Sex
- Female
- 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 | D13814 | MN | Primary |
Addresses
Primary practice location
9600 Upland LN N Ste 200
Maple Grove, MN 55369-4496
Mailing address
4749 Maryland Ave N
Crystal, MN 55428-4635
Phone (763) 772-6304
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 |
|---|---|---|---|
| D13814 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grove Health Dental PLLC | Current | Accepting new patients | |
| PDG, P.a. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Maple Grove, MN
- NPI 1710684196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494892800000",
"number": "1851828214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4749 MARYLAND AVE N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554284635",
"telephone_number": "763-772-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 UPLAND LN N STE 200",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694496",
"telephone_number": "763-416-0037",
"fax_number": "763-420-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMGREN",
"first_name": "JANNA",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-16",
"last_updated": "2017-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D13814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.