Provider Demographics
NPI:1588738298
Name:HESS, DAVID H (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:HESS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 ROCKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1623
Mailing Address - Country:US
Mailing Address - Phone:952-484-2040
Mailing Address - Fax:
Practice Address - Street 1:2202 ROCKSTONE LN
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-1623
Practice Address - Country:US
Practice Address - Phone:952-484-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2776152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN752042500Medicaid
MNU9425Medicare UPIN
MN410002021Medicare ID - Type Unspecified
MN752042500Medicaid