Individual provider Active NPI

Amira Yagi, DDS

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1003290701
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D15391 Issued in MN
Practice address
2220 Plymouth Ave N
Minneapolis, MN 55411-3600
Phone
(612) 543-3525
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D15391 MN Primary

Addresses

Primary practice location

2220 Plymouth Ave N
Minneapolis, MN 55411-3600

Mailing address

2220 Plymouth Ave N
Minneapolis, MN 55411-3600
Phone (612) 543-3525

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160212001991 IA Order and Referring Only - DentistPractitioner - Dentist 1456654490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D15391MNMDGeneral Practice Dentistry

Networks

  • NM HMO C-SNP
  • TX HMO D-SNP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1003290701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 PLYMOUTH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113600",
            "telephone_number": "612-543-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 PLYMOUTH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113600",
            "telephone_number": "612-543-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGI",
        "first_name": "AMIRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.