Individual provider Active NPI

Danae Marie Kotula, DT

  • Advanced Practice Dental Therapist
  • Minneapolis, MN
National Provider Identifier
1083970750
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice Dental TherapistTaxonomy code 125K00000X
License
DT7 Issued in MN
Practice address
2001 Bloomington Ave
Minneapolis, MN 55404-3074
Phone
(612) 301-0918
NPI assigned
Apr 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Dental Therapist 125K00000X DT7 MN Primary
Dental Therapist 125J00000X DT7 MN

Addresses

Primary practice location

2001 Bloomington Ave
Minneapolis, MN 55404-3074

Mailing address

2001 Bloomington Ave
Minneapolis, MN 55404-3074

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
DT7MNMDAdvanced Practice Dental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1083970750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074",
            "telephone_number": "612-301-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTULA",
        "first_name": "DANAE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-07",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "MN",
            "license": "DT7",
            "primary": true
        },
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT7",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.