Derek Daniel Abramowski, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13279 Issued in MN

Practice address

201 Sandberg Rd
Monticello, MN 55362-8906

Phone

(763) 295-5400

Fax

(763) 295-1785

NPI assigned

Jul 1, 2013

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

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

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.

• Derek Abramowski DDS

  dba Southside Dental Center

  • Dental Clinic/Center
  • Monticello, MN
  • NPI 1538533989
  NPD (past) Authorized official
• MSP Dentistry, Inc.

  • Preferred Provider Organization
  • Champlin, MN
  • NPI 1558719922
  NPD (past)
• Twin Cities Dental, PA

  • General Practice Dentistry
  • Champlin, MN
  • NPI 1376877316
  NPD (past)

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1952741290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12027 BUSINESS PARK BLVD N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553164526",
            "telephone_number": "763-421-7900",
            "fax_number": "763-421-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SANDBERG RD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628906",
            "telephone_number": "763-295-5400",
            "fax_number": "763-295-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMOWSKI",
        "first_name": "DEREK",
        "middle_name": "DANIEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Mark Adix, PSYD
• Aegis Group Practice LLC
• Riley Ahrndt, PT, DPT, CSCS
• Melissa Akerman, MPT
• Laura Ann Alter

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.