Mary L Sedivy, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11180 Issued in MN

Practice address

1480 Yankee Doodle Rd
Eagan, MN 55121-1801

Phone

(651) 452-3333

NPI assigned

Apr 25, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Cassandra L Zirbel DDS Ms

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eagan, MN
  • NPI 1790905966
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972722908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 YANKEE DOODLE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211801",
            "telephone_number": "651-452-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 YANKEE DOODLE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211801",
            "telephone_number": "651-452-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDIVY",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "11180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Schwieters Medical PLLC
• Bryan J Schwieters, MD
• Scott L Bjerke DDS PA
• Dylan Scott, PT
• Courtney Seaborg, MSW, LICSW
• Sempron Medical Supplier LLC
• Seo, LLC
• Serenity Behavioral Health LLC
• Serenity Support Services LLC
• Serenity Therapy Center LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Eagan, MN
• Providers in Eagan, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• 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.

Verify at the official NPI Registry.