Individual provider Active NPI

George Marcus Noesen, D.D.S.

  • General Practice Dentistry
  • Red Wing, MN
National Provider Identifier
1902950389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9876 Issued in MN
Practice address
608 Technology Dr
Red Wing, MN 55066-2846
Phone
(651) 388-1806
Fax
(651) 385-0432
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D9876 MN Primary

Addresses

Primary practice location

608 Technology Dr
Red Wing, MN 55066-2846

Mailing address

608 Technology Dr
Red Wing, MN 55066-2846
Phone (651) 388-1806

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
I20161129001752 MN Order and Referring Only - DentistPractitioner - Dentist 4082994512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9876MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Asp Dental, PC PastSince Oct 4, 2020 Accepting new patients
Noesen and Associates PA 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902950389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 TECHNOLOGY DR",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662846",
            "telephone_number": "651-388-1806",
            "fax_number": "651-385-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 TECHNOLOGY DR",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662846",
            "telephone_number": "651-388-1806",
            "fax_number": "651-385-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOESEN",
        "first_name": "GEORGE",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

Verify at the official NPI Registry.