Individual provider Active NPI

Mubarak Hassan Dayur

  • Adult Mental Health Clinic/Center
  • Burnsville, MN
National Provider Identifier
1104673805
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Practice address
1500 McAndrews Rd W Ste 204
Burnsville, MN 55337-4445
Phone
(612) 402-9183
NPI assigned
May 1, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MN Primary

Addresses

Primary practice location

1500 McAndrews Rd W Ste 204
Burnsville, MN 55337-4445

Mailing address

1500 McAndrews Rd W Ste 204
Burnsville, MN 55337-4445
Phone (612) 402-9183

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

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1104673805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 204",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374445",
            "telephone_number": "612-402-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MCANDREWS RD W STE 204",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374445",
            "telephone_number": "612-402-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYUR",
        "first_name": "MUBARAK",
        "middle_name": "HASSAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.