Thu Doan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14932 Issued in MN

Practice address

4959 Excelsior Blvd Ste 200
St Louis Park, MN 55416-3003

Phone

(952) 260-5323

NPI assigned

Jun 19, 2023

Last updated

Jun 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1093490054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4146 TRAIL RIDGE LN",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 EXCELSIOR BLVD STE 200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163003",
            "telephone_number": "952-260-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "THU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nona Dietrich
• Dinner at Your Door
• Keely Dinse, DO
• Jay Allen Dirks, M.D.
• Kayleigh Dittes, MD
• Kristin Linforth Dobberke, SLP
• Doc Squad, LLC
• Elizabeth Dockendorf
• Lauren Doda, D.O.
• Holly Jo Dodds, CCC-A

• General Practice Dentistry in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.