Active NPI
Edward J Stec, D.D.S, M.S
- Endodontics
- Forest Lake, MN
National Provider Identifier
1992727010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 9920
- Practice address
- 25 Lake St N
Ste 110
Forest Lake, MN 55025-2535 - Phone
- (651) 464-7388
- Fax
- (651) 982-6236
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 9920 | MN | Primary |
Addresses
Primary practice location
25 Lake St N
Ste 110
Forest Lake, MN 55025-2535
Mailing address
25 Lake St N
Ste 110
Forest Lake, MN 55025-2535
Phone (651) 464-7388
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9920 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992727010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 LAKE ST N",
"address_2": "STE 110",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252535",
"telephone_number": "651-464-7388",
"fax_number": "651-982-6236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 LAKE ST N",
"address_2": "STE 110",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252535",
"telephone_number": "651-464-7388",
"fax_number": "651-982-6236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEC",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S, M.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MN",
"license": "9920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, 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.