Individual provider Active NPI

Francesca Catibog, DDS

  • General Practice Dentistry
  • Eden Prairie, MN
National Provider Identifier
1912439480
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14081 Issued in MN
Practice address
9613 Anderson Lakes Pkwy
Eden Prairie, MN 55344-4155
Phone
(951) 941-0470
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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 D14081 MN Primary

Addresses

Primary practice location

9613 Anderson Lakes Pkwy
Eden Prairie, MN 55344-4155

Mailing address

9613 Anderson Lakes Pkwy
Eden Prairie, MN 55344-4155
Phone (951) 941-0470

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
I20170831000978 MN Order and Referring Only - DentistPractitioner - Dentist 2567735277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14081MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Lakes Dental LLC CurrentSince May 14, 2023 Accepting new patients
PDG, P.a. General Practice Past Accepting new patients

Locations

9613 Anderson Lakes Pkwy
Eden Prairie, MN 55344
Phone (952) 941-0470

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1912439480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9613 ANDERSON LAKES PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553444155",
            "telephone_number": "951-941-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9613 ANDERSON LAKES PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553444155",
            "telephone_number": "951-941-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATIBOG",
        "first_name": "FRANCESCA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.