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Active NPI 1205030491 Individual Practitioner Male Practitioner

Dr. Jonathan Isak Siverson , DDS

Dentist - General Practice • White Bear Lake, MN

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Siverson, DDS is a registered healthcare professional specializing in Dentist - General Practice in White Bear Lake, MN. Practice services are available at 4700 WHITE BEAR PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4700 White Bear Pkwy

White Bear Lake, MN 551103336

Telephone 6517627677
Fax 6517621861
Associated Practice Facility / Clinic
🏢 Isaacson Gentle Dentistry Facility NPI 1801037437

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in White Bear Lake, MN

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

Practicing in White Bear Lake, 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 D12410

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

5 Associated Practitioners
Dr. Jordan Dittberner , DDS

Dentist - General Practice

NPI 1174011597

Doctor of Dental Surgery

NPI 1396840559

Doctor of Dental Surgery

Dr. Daniel Isaacson , DDS

Dentist - General Practice

NPI 1598822637

Doctor of Dental Surgery

Dr. Michael Weisbrod , DDS

Dentist - General Practice

NPI 1659571107

Doctor of Dental Surgery

NPI 1851183990

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 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 4700 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 551103336 (Tel: 6517627677)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1291 NILES AVE, SAINT PAUL, MN 551161632 (Tel: 6123601713)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JONATHAN SIVERSON, D.D.S.

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

Dentist (License #D12410 in MN)

🟢
Initial NPI Registration & Enumeration June 12, 2007

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: 1205030491
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 12, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

1291 Niles Ave

Saint Paul, MN 551161632

Phone: 6123601713

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.