Individual provider Active NPI

Mary Kay Albertson, DDS

  • Dentist
  • St Paul, MN
National Provider Identifier
1114008158
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10373 Issued in MN
Practice address
1439 Arcade Street
St Paul, MN 55106
Phone
(651) 776-4766
Fax
(651) 776-6622
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10373 MN Primary

Addresses

Primary practice location

1439 Arcade Street
St Paul, MN 55106

Mailing address

1439 Arcade Street
St Paul, MN 55106
Phone (651) 776-4766

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
10373MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114008158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 ARCADE STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-776-4766",
            "fax_number": "651-776-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 ARCADE STREET",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-776-4766",
            "fax_number": "651-776-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERTSON",
        "first_name": "MARY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "10373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.