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JORDAN DITTBERNER DDS
NPI 1174011597
Dentist - General Practice in White Bear Lake, MN

Active since May 01, 2018
4700 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110(651) 762-7677 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Dittberner Dds NPPES

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

JORDAN DITTBERNER DDS (NPI 1174011597) is an individual general practice provider in White Bear Lake, Minnesota, licensed in Wisconsin (1001789) and active in the NPI registry since May 2018. He maintains a secondary practice location in Osceola.

NPPES Registry Identity

NPI1174011597
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJORDAN DITTBERNERCredential: DDS
Location Address4700 WHITE BEAR PKWYWhite Bear Lake, MN 55110-3336
Mailing Address7504 115th St NWhite Bear Lake, MN 55110-6182 · (651) 308-1177
Phone(651) 762-7677
Sole ProprietorYes
Enumeration DateMay 1, 2018
✔ NPI 1174011597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · 1001789
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.
4700 WHITE BEAR PKWY, White Bear Lake, MN 55110
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Secondary Practice Location 1

Location 1108 Chieftain St.Osceola, WI 54020 · Phone (715) 294-2202

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 ›

Other Providers at the Same Location NPPES 5

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

DR. JONATHAN ISAK SIVERSON D.D.S.
Dentist (General Practice)
4700 WHITE BEAR PKWY
WHITE BEAR LAKE, MN 55110
Ramsey County (651) 762-7677
DR. DANIEL RICHARD ISAACSON DDS
Dentist (General Practice)
4700 WHITE BEAR PKWY
WHITE BEAR LAKE, MN 55110
Ramsey County (651) 762-7677
MICHAEL JULIUS WEISBROD DDS
Dentist (General Practice)
4700 WHITE BEAR PKWY
SAINT PAUL, MN 55110
Ramsey County (651) 762-7677
ISAACSON GENTLE DENTISTRY
Clinic/Center (Dental)
4700 WHITE BEAR PKWY
WHITE BEAR LAKE, MN 55110
Ramsey County (651) 762-7677
DR. CONNOR MICHAEL ISAACSON DDS
Dentist
4700 WHITE BEAR PKWY
WHITE BEAR LAKE, MN 55110
Ramsey County (651) 762-7677

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 Jordan Dittberner's NPI number?

The NPI number for Jordan Dittberner is 1174011597. It was assigned to this individual provider in the NPPES registry on May 1, 2018.

Where is Jordan Dittberner located?

Jordan Dittberner practices at 4700 White Bear Pkwy, White Bear Lake, MN 55110. The listed phone number is (651) 762-7677.

What is Jordan Dittberner's specialty?

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

What insurance does Jordan Dittberner 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 Delta Dental of Wisconsin, Inc. and 6 other insurers list Jordan Dittberner 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 Jordan Dittberner was last updated on May 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.