Individual provider Active NPI

Cynthia Jhamilex Duta-Llangari, DDS

  • Dentist
  • Apple Valley, MN
National Provider Identifier
1013754092
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15144 Issued in MN
Practice address
6520 150TH St W Ste 300
Apple Valley, MN 55124-6584
Phone
(952) 241-5888
Fax
(952) 241-5887
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15144 MN Primary

Addresses

Primary practice location

6520 150TH St W Ste 300
Apple Valley, MN 55124-6584

Mailing address

3205 19TH Ave S
Minneapolis, MN 55407-2401
Phone (615) 927-9764

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
D15144MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
PDG, P.a. PastSince Jul 21, 2024 Accepting new patients

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": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1013754092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 19TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072401",
            "telephone_number": "615-927-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 150TH ST W STE 300",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246584",
            "telephone_number": "952-241-5888",
            "fax_number": "952-241-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTA-LLANGARI",
        "first_name": "CYNTHIA",
        "middle_name": "JHAMILEX",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.