Individual provider Active NPI

Kelsi McEnaney, DDS

  • Dentist
  • West St Paul, MN
National Provider Identifier
1003702093
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15308 Issued in MN
Practice address
2036 Robert St S
West St Paul, MN 55118-3923
Phone
(651) 457-5762
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15308 MN Primary

Addresses

Primary practice location

2036 Robert St S
West St Paul, MN 55118-3923

Mailing address

633 Ontario St SE Apt 208
Minneapolis, MN 55414-3281
Phone (406) 493-2295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D15308MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Dental Partners, PLLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

2036 Robert St S
West St Paul, MN 55118
Phone (651) 457-5762

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1003702093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 ONTARIO ST SE APT 208",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143281",
            "telephone_number": "406-493-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 ROBERT ST S",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183923",
            "telephone_number": "651-457-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENANEY",
        "first_name": "KELSI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.