Individual provider Active NPI

James Kevin Zenk, DDS

  • Dentist
  • Montevideo, MN
National Provider Identifier
1952492035
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8908 Issued in MN
Practice address
1317 Grove Ave
Montevideo, MN 56265
Phone
(320) 269-6416
Fax
(320) 269-8136
NPI assigned
Sep 27, 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 8908 MN Primary

Addresses

Primary practice location

1317 Grove Ave
Montevideo, MN 56265

Mailing address

1317 Grove Ave
Montevideo, MN 56265
Phone (320) 269-6416

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
I20171003007212 MN Practitioner - Oral Surgery 3173828498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8908MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Aug 12, 2017 Accepting new patients
Regents of the University of Minnesota CurrentSince Aug 12, 2017 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients

Locations

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952492035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 GROVE AVE",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "56265",
            "telephone_number": "320-269-6416",
            "fax_number": "320-269-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 GROVE AVE",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "56265",
            "telephone_number": "320-269-6416",
            "fax_number": "320-269-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENK",
        "first_name": "JAMES",
        "middle_name": "KEVIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "8908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montevideo, MN

Sources for this page

Verify at the official NPI Registry.