Gordon Dale Engstrand, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9825 Issued in MN

Practice address

2000 Plymouth Rd
Suite 357
Minnetonka, MN 55305-2366

Phone

(952) 544-1449

Fax

(952) 544-7656

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Modern Dentistry of Minnetonka PLLC

  • General Practice Dentistry
  • Minnetonka, MN
  • NPI 1134807878
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922150770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 357",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "952-544-1449",
            "fax_number": "952-544-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 357",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "952-544-1449",
            "fax_number": "952-544-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGSTRAND",
        "first_name": "GORDON",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "D253899",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Keith Engel, MD
• Martha Ruth Engelbrekt, MD
• Cynthia Diane Engelkes, M.A., L.A.M.F.T.
• Brittany Nicole Engelmann
• Meagan Evelyn Englert
• Melinda Jane Enright, LICSW
• ENT & Sleep Clinics Minnesota LLC
• Nam Yong Eom
• Epiphany Care Homes LLC
• Equilibrium Brain Body Balance

• General Practice Dentistry in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.