Individual provider Active NPI

Bradley Duane Swingdorf, DDS

  • Dentist
  • Inver Grove Heights, MN
National Provider Identifier
1942282231
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8603 Issued in MN
Practice address
6105 Cahill Avenue East
Inver Grove Heights, MN 55076-1308
Phone
(651) 451-9101
Fax
(651) 451-9887
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8603 MN Primary

Addresses

Primary practice location

6105 Cahill Avenue East
Inver Grove Heights, MN 55076-1308

Mailing address

8329 Delaney Circle
Inver Grove Heights, MN 55076-1308
Phone (651) 451-3278

Other identifiers 1

IdentifierTypeStateIssuer
942018500OtherMNMEDICAL ASSISTANCE

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

LicenseStateTypeSpecialty
8603MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cahill Dental Care PA PastSince Jun 1, 2015 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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1942282231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8329 DELANEY CIRCLE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761308",
            "telephone_number": "651-451-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 CAHILL AVENUE EAST",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761308",
            "telephone_number": "651-451-9101",
            "fax_number": "651-451-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINGDORF",
        "first_name": "BRADLEY",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "8603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "942018500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.