Individual provider Active NPI

Alexis Hoekstra, DMD

  • Dentist
  • Oakdale, MN
National Provider Identifier
1164150215
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15167 Issued in MN
Practice address
1077 Helmo Ave N Ste 130
Oakdale, MN 55128-5546
Phone
(651) 731-6464
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15167 MN Primary
General Practice Dentistry 1223G0001X 6001055-15 WI

Addresses

Primary practice location

1077 Helmo Ave N Ste 130
Oakdale, MN 55128-5546

Mailing address

4600 Atlas PL
Woodbury, MN 55129-4429

Other practice location 1

460 Crescent St
Menomonie, WI 54751-1827
Phone (715) 235-2211

Other practice location 2

1975 11th Ave E
Maplewood, MN 55109-5148
Phone (651) 770-2900

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
D15167MNMDDentist
6001055-15WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1164150215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 ATLAS PL",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 HELMO AVE N STE 130",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285546",
            "telephone_number": "651-731-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Crescent St",
            "address_purpose": "LOCATION",
            "city": "Menomonie",
            "state": "WI",
            "postal_code": "547511827",
            "country_code": "US",
            "telephone_number": "715-235-2211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1975 11th Ave E",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551095148",
            "country_code": "US",
            "telephone_number": "651-770-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOEKSTRA",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15167",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001055-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, MN

Sources for this page

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