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Deactivated NPI 1386715316 Deactivated / Inactive NPI Male Practitioner

Dr. Gregory Wayne Nelson , DDS

Dentist • Rogers, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gregory Nelson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 13, 2006
NPI Deactivation Date July 30, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Gregory Nelson, DDS was a registered Dentist practicing in Rogers, MN. Throughout an active medical career spanning 20 years, Dr. Nelson provided care at the practice location at 21370 JOHN MILLESS DR until profile deactivation on 2026-07-30.

Practice Location & Contact Primary Location

Practice Address

21370 John Milless Dr

Rogers, MN 553740177

Telephone 7634282217
Fax 7634288586
Associated Practice Facility / Clinic
🏢 Larry M Schanus Pa Facility NPI 1619075058

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Rogers, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.6 Yrs
Regional Practice Density
5 Specialists

Practicing in Rogers, MN (1863 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MN D9395

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.

Practice Associates & Co-Workers

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

3 Associated Practitioners
Dr. Matthew Dale , DDS

Dentist - General Practice

NPI 1003028861

Doctor of Dental Surgery

NPI 1710058128

Doctor of Dental Surgery

NPI 1750452157

Career & Practice History Timeline

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

9 Historical Events
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NPI Profile Deactivated July 30, 2026

Record deactivated on July 30, 2026

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Updated Practice Location July 02, 2019

Registered at 21410 136TH AVE NORTH SUITE #109, ROGERS, MN 55374 (Tel: 7634282217)

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Updated Business Mailing Address July 02, 2019

Registered at 21410 136TH AVE NORTH SUITE #109, ROGERS, MN 55374 (Tel: 7634282217)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 21370 JOHN MILLESS DR, ROGERS, MN 553740177 (Tel: 7634282217)

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Updated Business Mailing Address July 08, 2007

Registered at 17352 81ST AVE N, MAPLE GROVE, MN 553111770 (Tel: 7634940886)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GREGORY NELSON, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D9395 in MN)

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Initial NPI Registration & Enumeration November 13, 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: 1386715316
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 13, 2006
Last Update: July 08, 2007
Deactivation Date: July 30, 2026

Mailing Address

17352 81st Ave N

Maple Grove, MN 553111770

Phone: 7634940886

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.