Active NPI
Lauren Esposito, ADT
- Advanced Practice Dental Therapist
- Faribault, MN
National Provider Identifier
1033642947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Dental Therapist
- License
- DT56
- Practice address
- 1575 20TH St NW
Suite 102
Faribault, MN 55021-2930 - Phone
- (507) 334-6433
- Fax
- (507) 334-0044
- NPI assigned
- Apr 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Dental Therapist | 125K00000X | DT56 | MN | Primary |
Addresses
Primary practice location
1575 20TH St NW
Suite 102
Faribault, MN 55021-2930
Mailing address
1575 20TH St NW
Suite 102
Faribault, MN 55021-2930
Phone (507) 334-6433
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
| License | State | Type | Specialty |
|---|---|---|---|
| DT56 | MN | MD | Advanced Practice Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Heights Dental Group PA | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Faribault, MN
- NPI 1932247921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1033642947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 20TH ST NW",
"address_2": "SUITE 102",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550212930",
"telephone_number": "507-334-6433",
"fax_number": "507-334-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 20TH ST NW",
"address_2": "SUITE 102",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550212930",
"telephone_number": "507-334-6433",
"fax_number": "507-334-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPOSITO",
"first_name": "LAUREN",
"credential": "ADT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "125K00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Dental Therapist",
"state": "MN",
"license": "DT56",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.