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Active NPI 1356326029 Individual Practitioner Male Practitioner

Dr. Derek L Gustafson , DDS

Dentist - General Practice • New Brighton, MN

Professional Overview & Biography Verified Profile Summary

Dr. Derek Gustafson, DDS is a registered healthcare professional specializing in Dentist - General Practice in New Brighton, MN. Practice services are available at 2467 15TH ST NW under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2467 15th St Nw
Suite A

New Brighton, MN 551125596

Telephone 6516334883
Fax 6516334998
Associated Practice Facility / Clinic
🏢 Dr My Pang Kou Vang Dds, Pllc Facility NPI 1174419923

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in New Brighton, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
10 Specialists

Practicing in New Brighton, 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 12387

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License NM DD2591

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Dental License
DD2591
Commercial Insurance / Payer ID License
12387 (MN)

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Jeffrey Benson , DDS

Dentist - General Practice

NPI 1407951536

Doctor of Dental Surgery

NPI 1417130667

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 23, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2008

Registered at 2467 15TH ST NW, SUITE A, NEW BRIGHTON, MN 551125596 (Tel: 6516334883)

📍
Updated Business Mailing Address July 23, 2008

Registered at 2467 15TH ST NW, SUITE A, NEW BRIGHTON, MN 551125596 (Tel: 6516334883)

👤
Provider Name / Credentials Updated July 23, 2008

Recorded as DEREK GUSTAFSON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2008

Dentist (License #DD2591 in NM)

🟢
Initial NPI Registration & Enumeration December 14, 2005

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: 1356326029
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 14, 2005
Last Update: July 23, 2008
Sole Proprietor: Yes

Mailing Address

2467 15th St Nw, Suite A

New Brighton, MN 551125596

Phone: 6516334883

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.