Derek L Gustafson is a New Brighton, Minnesota based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Derek L Gustafson is
12387 for General Practice Dentistry in Minnesota. His current practice location is
2467 15th St Nw, Suite A, New Brighton. Patients can reach him at
651-633-4883.
Derek L Gustafson is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Derek L Gustafson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Derek L Gustafson |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 2467 15th St Nw, Suite A, New Brighton,
Minnesota, 55112-5596 |
| Phone: | 651-633-4883 |
| Fax: | 651-633-4998 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1356326029 |
| NPI Enumeration Date: | 14 Dec, 2005 |
| NPI Last Update On: | 23 Jul, 2008 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Derek L Gustafson are as mentioned below.
| License Number | Specialization | State | Status | |
| 12387 | General Practice Dentistry | Minnesota | Primary | |
| DD2591 | Dentistry | New Mexico | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Derek L Gustafson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| DD2591 | Other | | DENTAL LICENSE |
| 12387 | Other | Minnesota | LICENSE |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2467 15th St Nw, Suite A
New Brighton, Minnesota |
| Zip: | 55112-5596 |
| Phone Number: | 651-633-4883 |
| Fax Number: | 651-633-4998 |
Patients can reach Derek L Gustafson at
2467 15th St Nw, Suite A, New Brighton, Minnesota or can
call to book an appointment on 651-633-4883.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.