Provider Demographics
NPI:1487697967
Name:TUNGSETH, DENIS C (MD)
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:C
Last Name:TUNGSETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1221 NICOLLET AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2420
Mailing Address - Country:US
Mailing Address - Phone:612-573-2232
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:1221 NICOLLET AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2420
Practice Address - Country:US
Practice Address - Phone:612-573-2232
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN208342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30120700Medicaid
MN1010220OtherPREFERRED ONE
IA0985960Medicaid
MN300065115OtherRAILROAD MEDICARE MN
MNHP14585OtherHEALTHPARTNERS
MN16707TUOtherBLUE CROSS
MN100706OtherUCARE
MN300G1TUOtherBLUE CROSS
MN23024OtherAMERICA'S PPO
MN436568200Medicaid
MN300G1TUOtherBLUE CROSS
MN300065115OtherRAILROAD MEDICARE MN
MND33494Medicare UPIN
MN300000359Medicare PIN