Kyra A. Iwen, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D12519 Issued in MN

Practice address

515 Delaware St SE
School of Dentistry- Division of Orthodontics
Minneapolis, MN 55455-0357

Phone

(651) 278-7892

NPI assigned

Jun 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kyra A. Toulouse Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1083876767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 MONTANA AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551173443",
            "telephone_number": "651-278-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "SCHOOL OF DENTISTRY- DIVISION OF ORTHODONTICS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "651-278-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWEN",
        "first_name": "KYRA",
        "middle_name": "A.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D12519",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYRA",
            "last_name": "TOULOUSE",
            "middle_name": "A.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Grace Ivester Tetrault, MSW, LICSW
• Ivory Dental
• Zalaya Keyena Ivy, MD
• Carlos A Iwamoto, M.D.
• Taylor Lynn Iwaszko Wagner, CNP-PNP
• Uroghupatei Paul Iyegha, MD
• Vishnu Iyer, MD
• Izaak Davison-Kerwood
• Adaobi Nneamaka Izuora
• Izzy Homecare LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.