Individual provider Active NPI

Rebecca Ann Frenz, DDS

  • Dentist
  • Blaine, MN
National Provider Identifier
1952989717
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14561 Issued in MN
Practice address
10961 Club West Pkwy Ste 240
Blaine, MN 55449-5869
Phone
(763) 780-1292
NPI assigned
Mar 31, 2021
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14561 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10961 Club West Pkwy Ste 240
Blaine, MN 55449-5869

Mailing address

5800 Otter Lake Rd
White Bear Lake, MN 55110-6419
Phone (651) 895-6451

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
I20220826001470 MN Practitioner - Dentist 8325422264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Multi-Specialty Current Accepting new patients
Group Health, Inc. Multi-Specialty CurrentSince Jul 25, 2022 Accepting new patients
Group Health, Inc. Dentist CurrentSince Jul 25, 2022 Accepting new patients

Locations

10961 Club West Pkwy
Ste 240
Minneapolis, MN 55449
Phone (763) 780-1292

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 3

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1952989717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 OTTER LAKE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551106419",
            "telephone_number": "651-895-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10961 CLUB WEST PKWY STE 240",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495869",
            "telephone_number": "763-780-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRENZ",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "14561",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.