Nathan Luitjens, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14792 Issued in MN

Practice address

1950 Center Creek Dr Ste 200
Fairmont, MN 56031-3430

Phone

(507) 238-2812

NPI assigned

Jun 29, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairmont Dental Professionals LLC

  • Dentist
  • Fairmont, MN
  • NPI 1730850306
  NPD

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1922730688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 N NORTH AVE",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311653",
            "telephone_number": "507-822-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CENTER CREEK DR STE 200",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560313430",
            "telephone_number": "507-238-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUITJENS",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeview Methodist Health Care Center
• Taylor Autumn Landkamer, FNP-C
• Thomas Joe Larson, DDS
• William J Lee, M.D.
• Brooke Loge, APRN, AGCNS, DNP
• John Bruce Lund, DC
• Lynn H Reeve DDS PA
• Luke Matthew Madsen, D.P.M.
• Andrew S Maiers, DO
• Sarah Martinson

• Dentist in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.