Individual provider Active NPI

Andrada Lavinia Hrdlicka, RDH

  • Dental Hygienist
  • Saint Paul, MN
National Provider Identifier
1124304373
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H8357 Issued in MN
Practice address
1026 7TH St W
Saint Paul, MN 55102-3828
Phone
(651) 241-1000
Fax
(651) 241-1138
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H8357 MN Primary
Dental Hygienist 124Q00000X 906414 CO

Addresses

Primary practice location

1026 7TH St W
Saint Paul, MN 55102-3828

Mailing address

1026 7TH St W
Saint Paul, MN 55102-3828
Phone (651) 241-1000

Other identifiers 1

IdentifierTypeStateIssuer
61823376MedicaidCO

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
906414COMDDental Hygienist
H8357MNMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1124304373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023828",
            "telephone_number": "651-241-1000",
            "fax_number": "651-241-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023828",
            "telephone_number": "651-241-1000",
            "fax_number": "651-241-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRDLICKA",
        "first_name": "ANDRADA",
        "middle_name": "LAVINIA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H8357",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "906414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61823376",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.