Individual provider Active NPI

John M Woell, DENTIST

  • Dentist
  • Richfield, MN
National Provider Identifier
1922196294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8581 Issued in MN
Practice address
1717 E 66TH St
Richfield, MN 55423-2798
Phone
(612) 861-7109
Fax
(612) 253-7422
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X D8581 MN Primary

Addresses

Primary practice location

1717 E 66TH St
Richfield, MN 55423-2798

Mailing address

1717 East 66TH Street
Richfield, MN 55423-2798
Phone (612) 861-7109

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
I20160301001595 MN Order and Referring Only - DentistPractitioner - Dentist 2961707880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D8581MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Care Center PA Dentist Past Accepting new patients

Organizations & group practices 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922196294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 EAST 66TH STREET",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232798",
            "telephone_number": "612-861-7109",
            "fax_number": "612-253-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E 66TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232798",
            "telephone_number": "612-861-7109",
            "fax_number": "612-253-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOELL",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D8581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.