Individual provider Active NPI

Chad Engelbrecht, DDS

  • Dentist
  • Woodbury, MN
National Provider Identifier
1902010275
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11433 Issued in MN
Practice address
7650 Currell Blvd Ste 200
Woodbury, MN 55125-8209
Phone
(651) 730-9266
Fax
(651) 578-0444
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11433 MN Primary

Addresses

Primary practice location

7650 Currell Blvd Ste 200
Woodbury, MN 55125-8209

Mailing address

7650 Currell Blvd Ste 200
Woodbury, MN 55125-8209
Phone (651) 730-9266

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160129000597 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365745098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11433MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1902010275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 CURRELL BLVD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258209",
            "telephone_number": "651-730-9266",
            "fax_number": "651-578-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 CURRELL BLVD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258209",
            "telephone_number": "651-730-9266",
            "fax_number": "651-578-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBRECHT",
        "first_name": "CHAD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.