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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

THOMAS JOHN CORNELISSEN D.D.S.
NPI 1053364513
Dentist - General Practice in Minneapolis, MN

Active since May 18, 2006PECOS Enrolled
3262 W LAKE ST, MINNEAPOLIS, MN 55416(612) 925-6010(612) 925-4907 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Thomas John Cornelissen D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS JOHN CORNELISSEN D.D.S. (NPI 1053364513) is an individual general practice provider in Minneapolis, Minnesota, licensed in Minnesota (9908) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053364513
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameTHOMAS JOHN CORNELISSENCredential: D.D.S.
Location Address3262 W LAKE STMinneapolis, MN 55416-4512
Mailing Address3262 W Lake StMinneapolis, MN 55416-4512 · (612) 925-6010 · Fax (612) 925-4907
Phone(612) 925-6010
Fax(612) 925-4907
Sole ProprietorNo
Enumeration DateMay 18, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1053364513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · 9908
Definition

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.

3262 W LAKE ST, Minneapolis, MN 55416
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas John Cornelissen D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WOLFE DENTAL PLLC
Clinic/Center (Dental)
3262 W LAKE ST
MINNEAPOLIS, MN 55416
Hennepin County (612) 925-6010

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Cornelissen's NPI number?

The NPI number for Thomas Cornelissen is 1053364513. It was assigned to this individual provider in the NPPES registry on May 18, 2006.

Where is Thomas Cornelissen located?

Thomas Cornelissen practices at 3262 W Lake St, Minneapolis, MN 55416. The listed phone number is (612) 925-6010.

What is Thomas Cornelissen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Thomas Cornelissen enrolled in Medicare?

Yes. Thomas Cornelissen is registered in the Medicare PECOS enrollment system.

What insurance does Thomas Cornelissen accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Thomas Cornelissen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Cornelissen was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.