Active NPI
Robert Edgar Eng, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Woodbury, MN
National Provider Identifier
1902979206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 08122
- Practice address
- 3100 Woodbury Drive
Woodbury, MN 55129 - Phone
- (651) 503-6885
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 08122 | MN | Primary |
Addresses
Primary practice location
3100 Woodbury Drive
Woodbury, MN 55129
Mailing address
3866 Widgeon Way
Eagan, MN 55123
Phone (651) 503-6885
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 |
|---|---|---|---|
| 08122 | MN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1902979206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3866 WIDGEON WAY",
"city": "EAGAN",
"state": "MN",
"postal_code": "55123",
"telephone_number": "651-503-6885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 WOODBURY DRIVE",
"city": "WOODBURY",
"state": "MN",
"postal_code": "55129",
"telephone_number": "651-503-6885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENG",
"first_name": "ROBERT",
"middle_name": "EDGAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MN",
"license": "08122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.