Individual provider Active NPI

Mitchell Nathan Beinlich

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1992324412
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14431 Issued in MN
Practice address
1670 Beam Ave
Saint Paul, MN 55109-1201
Phone
(651) 925-8400
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14431 MN Primary

Addresses

Primary practice location

1670 Beam Ave
Saint Paul, MN 55109-1201

Mailing address

927 Ridge Pass
Hudson, WI 54016-7503
Phone (715) 808-1700

Other practice location 1

1801 W Wisconsin Ave
Milwaukee, WI 53233-2186
Phone (414) 288-6790

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14431MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1992324412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 RIDGE PASS",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167503",
            "telephone_number": "715-808-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 BEAM AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551091201",
            "telephone_number": "651-925-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332186",
            "country_code": "US",
            "telephone_number": "414-288-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEINLICH",
        "first_name": "MITCHELL",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.