Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Thomas John Cornelissen, DDS

Individual provider General Practice Dentistry · NPI 1053364513

Thomas John Cornelissen, DDS practises General Practice Dentistry in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3262 W Lake St
Minneapolis, MN 55416-4512
Phone: (612) 925-6010
Fax: (612) 925-4907
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 9908 (MN)

Record details

NPI number1053364513
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 18, 2006
Last updated in NPPESJuly 13, 2026

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