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DR. EDMUND THEIS D.D.S.
NPI 1447322532
Dentist - General Practice in Bloomington, MN

Active since November 14, 2006Opted out of Medicare · through Jan 2, 2027
4200 W OLD SHAKOPEE RD, SUITE 223, BLOOMINGTON, MN 55437(952) 881-8404(952) 881-9520 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Edmund Theis D.d.s. NPPES

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

DR. EDMUND THEIS D.D.S. (NPI 1447322532) is an individual general practice provider in Bloomington, Minnesota, licensed in Minnesota (8644) and active in the NPI registry since November 2006. He has opted out of Medicare through January 2, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1447322532
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. EDMUND THEISCredential: D.D.S.
Location Address4200 W OLD SHAKOPEE RD, SUITE 223Bloomington, MN 55437-2976
Mailing Address4200 W Old Shakopee Rd, Suite 223Bloomington, MN 55437-2976 · (952) 881-8404 · Fax (952) 881-9520
Phone(952) 881-8404
Fax(952) 881-9520
Sole ProprietorNo
Enumeration DateNovember 14, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1447322532 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 · 8644
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.
4200 W OLD SHAKOPEE RD, Bloomington, MN 55437
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Edmund Theis D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 2, 2017 through January 2, 2027.

Opt-Out Effective DateJanuary 2, 2017
Opt-Out In Effect ThroughJanuary 2, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55437 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 4

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

DR. KRIS J KALENDA DDS
Dentist
4200 W OLD SHAKOPEE RD, SUITE 221
BLOOMINGTON, MN 55437
Hennepin County (952) 881-0201
PDG,P.A.
Dentist (General Practice)
4200 W OLD SHAKOPEE RD, SUITE 100
BLOOMINGTON, MN 55437
Hennepin County (952) 831-6126
DR. TIMOTHY JOHN ISAACSON D.D.S.
Dentist (General Practice)
4200 W OLD SHAKOPEE RD, SUITE 223
BLOOMINGTON, MN 55437
Hennepin County (952) 881-8404
DR. DANA JOHN ISAACSON D.D.S.
Dentist (General Practice)
4200 W OLD SHAKOPEE RD, SUITE 223
BLOOMINGTON, MN 55437
Hennepin County (952) 881-8404

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 Edmund Theis's NPI number?

The NPI number for Edmund Theis is 1447322532. It was assigned to this individual provider in the NPPES registry on November 14, 2006.

Where is Edmund Theis located?

Edmund Theis practices at 4200 W Old Shakopee Rd Suite 223, Bloomington, MN 55437. The listed phone number is (952) 881-8404.

What is Edmund Theis's specialty?

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

Is Edmund Theis enrolled in Medicare?

No. Edmund Theis has opted out of Medicare through January 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Edmund Theis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.