OPEN DOOR HEALTH CENTER – General Practice Dentistry, NPI 1114446283
General Practice Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for OPEN DOOR HEALTH CENTER
115 Broadway St S
Jordan, MN 553521664
Phone: (507) 388-2120
Type: Location
115, Broadway Street South, Jordan, Scott County, Minnesota, 55352, United States
JORDAN, MN 553521664
Phone: (507) 388-2120
Type: Location
1617 Weston CT STE 200
Skakopee, MN 553794717
Phone: (952) 492-6342
Fax: (652) 492-2631
Type: Location
1617 WESTON CT STE 200
SHAKOPEE, MN 553794717
Phone: (952) 492-6342
Fax: (652) 492-2631
Type: Location
309, Holly Lane, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO, MN 560015422
Phone: (507) 388-2120
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20150930001410 | O | Clinic/Group Practice | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55352)
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Reviews
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