Active NPI
Michelle Parker
- Dentist
- Stillwater, MN
National Provider Identifier
1972985364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1001108-15
- Practice address
- 13961 60TH St N
Stillwater, MN 55082-1053 - Phone
- (715) 235-2211
- NPI assigned
- Jun 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1001108-15 | WI | Primary |
Addresses
Primary practice location
13961 60TH St N
Stillwater, MN 55082-1053
Mailing address
506 Crescent St
Menomonie, WI 54751-1829
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 |
|---|---|---|---|
| 1001108-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511136000000",
"number": "1972985364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 CRESCENT ST",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547511829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13961 60TH ST N",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550821053",
"telephone_number": "715-235-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-23",
"last_updated": "2017-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1001108-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.