Michael W. Gleysteen, DDS, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8118 Issued in MN

Legal business name

MICHAEL W. GLEYSTEEN, DDS, PA

Practice address

250 Central Ave N # 113
Wayzata, MN 55391-1206

Phone

(952) 473-7037

Fax

(952) 404-1664

NPI assigned

Jul 31, 2006

Last updated

Sep 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael W. Gleysteen, DDSNPI 1932407798

Title

Orthodontist

Phone

(952) 473-7037

Specialties & licenses 1

Addresses

Other names 1

• Wayzata Orthodontics Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael W. Gleysteen, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wayzata, MN
  • NPI 1932407798
  Authorized official Same address or phone

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1902812126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N # 113",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206",
            "telephone_number": "952-473-7037",
            "fax_number": "952-404-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N # 113",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206",
            "telephone_number": "952-473-7037",
            "fax_number": "952-404-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W. GLEYSTEEN, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "GLEYSTEEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "952-473-7037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "8118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayzata Orthodontics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.