Individual provider Active NPI

Lauren Esposito, ADT

  • Advanced Practice Dental Therapist
  • Faribault, MN
National Provider Identifier
1033642947
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice Dental TherapistTaxonomy code 125K00000X
License
DT56 Issued in MN
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

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DT56MNMDAdvanced Practice Dental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Heights Dental Group PA PastSince Apr 22, 2017 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.

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.

Verify at the official NPI Registry.