Individual provider Active NPI

Michael Korleski, DDS

  • Dentist
  • Cambridge, MN
National Provider Identifier
1972362457
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15305 Issued in MN
Practice address
140 Birch St N Ste 114
Cambridge, MN 55008-1507
Phone
(763) 347-4399
NPI assigned
Mar 18, 2024
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15305 MN Primary

Addresses

Primary practice location

140 Birch St N Ste 114
Cambridge, MN 55008-1507

Mailing address

140 Birch St N Ste 114
Cambridge, MN 55008-1507

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
I20251021000243 MN Practitioner - Dentist 2961990130

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Michigan School of Dentistry, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 Delaware St SE
7 220 Moos Tower
Minneapolis, MN 55455-0357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D15305MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Aug 7, 2025 Accepting new patients
Regents of the University of Minnesota CurrentSince Aug 7, 2025 Accepting new patients
Health Source Dental Clinic Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: mkorleski2760524@fairview.direct-ci.com

Organizations & group practices 4

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": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1972362457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N STE 114",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N STE 114",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081507",
            "telephone_number": "763-347-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORLESKI",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

Verify at the official NPI Registry.