Active NPI
John Henry Ehresmann, DDS
- General Practice Dentistry
- Northfield, MN
National Provider Identifier
1972679066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D8879
- Practice address
- 2011 Jefferson Rd
Heritage Dental Care LTD
Northfield, MN 55057 - Phone
- (507) 645-9543
- Fax
- (507) 645-5612
- NPI assigned
- Nov 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8879 | MN | Primary |
| General Practice Dentistry | 1223G0001X | 105054 | CO | |
| General Practice Dentistry | 1223G0001X | 06752 | IA | |
| General Practice Dentistry | 1223G0001X | 2893015 | WI |
Addresses
Primary practice location
2011 Jefferson Rd
Heritage Dental Care LTD
Northfield, MN 55057
Mailing address
2011 Jefferson Rd
Heritage Dental Care LTD
Northfield, MN 55057
Phone (507) 645-9543
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
| License | State | Type | Specialty |
|---|---|---|---|
| 06752 | IA | MD | Chiropractor |
| 105054 | CO | MD | General Practice Dentistry |
| D8879 | MN | MD | General Practice Dentistry |
| 2893015 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heritage Dental Care LTD | General Practice | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Northfield, MN
- NPI 1932329638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972679066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2011 JEFFERSON RD",
"address_2": "HERITAGE DENTAL CARE LTD",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "55057",
"telephone_number": "507-645-9543",
"fax_number": "507-645-5612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 JEFFERSON RD",
"address_2": "HERITAGE DENTAL CARE LTD",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "55057",
"telephone_number": "507-645-9543",
"fax_number": "507-645-5612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRESMANN",
"first_name": "JOHN",
"middle_name": "HENRY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D8879",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "105054",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "06752",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "2893015",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Northfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.