Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1538177944 Individual Practitioner Male Practitioner

Dr. Edgar Mantilla , DDS

Dentist - General Practice • Minneapolis, MN

Professional Overview & Biography Verified Profile Summary

Dr. Edgar Mantilla, DDS is a registered healthcare professional specializing in Dentist - General Practice in Minneapolis, MN. Practice services are available at 2001 BLOOMINGTON AVE S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2001 Bloomington Ave S

Minneapolis, MN 554043074

Telephone 6123013433
Fax 6126274205
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Minneapolis, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 33.0 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
214 Specialists

Practicing in Minneapolis, MN (2262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN D11889

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Emily Otteson , BAN, RN, PHN

Student in an Organized Health Care Education/Training Program

NPI 1023934072

BAN, Registered Nurse, PHN

Brenda Reiter , NP

Nurse Practitioner - Women's Health

NPI 1033149778

Nurse Practitioner

Dr. Michele Allen , MD

Family Medicine

NPI 1033153200

Doctor of Medicine (M.D.)

Dr. Lan Luu , MD, MPH

Internal Medicine

NPI 1033520986

Doctor of Medicine (M.D.), Master of Public Health

Andrea Davis , APRN

Nurse Practitioner - Family

NPI 1043720824

Advanced Practice Registered Nurse

Dr. Michael Aylward , MD

Internal Medicine

NPI 1053366575

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 24, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location October 24, 2014

Registered at 2001 BLOOMINGTON AVE S, MINNEAPOLIS, MN 554043074 (Tel: 6123013433)

📍
Updated Business Mailing Address October 24, 2014

Registered at 2001 BLOOMINGTON AVE S, MINNEAPOLIS, MN 554043074 (Tel: 6123013433)

👤
Provider Name / Credentials Updated October 24, 2014

Recorded as EDGAR MANTILLA, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2014

Dentist (License #D11889 in MN)

🟢
Initial NPI Registration & Enumeration August 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1538177944
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2006
Last Update: October 24, 2014
Sole Proprietor: No

Mailing Address

2001 Bloomington Ave S

Minneapolis, MN 554043074

Phone: 6123013433

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.