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General NPI Number Information
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NPI Number | 1902813280
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Entity Type | Individual
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Provider Name | MICHAEL DEAN BAKKEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 14635 PENNOCK AVE SUITE 100
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City | APPLE VALLEY
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State | MN
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Zip | 55124-6430
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Country | US
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Telephone | 952-432-5509
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Fax | 952-891-4894
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Provider Business Mailing Address
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Address Line | 14635 PENNOCK AVE STE 100
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City | APPLE VALLEY
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State | MN
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Zip | 55124-6431
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Country | US
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Telephone | 952-432-5509
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Fax | 952-891-4894
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10867
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License Number State | MN
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