Individual provider Active NPI

Anne Beaudin, DMD

  • Prosthodontics
  • Minneapolis, MN
National Provider Identifier
1164918009
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
11015 Issued in ZZ
Practice address
515 Delaware St SE
Minneapolis, MN 55455-0357
Phone
(612) 626-2332
NPI assigned
Jul 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 11015 ZZ Primary

Addresses

Primary practice location

515 Delaware St SE
Minneapolis, MN 55455-0357

Mailing address

428 13TH Ave SE Apt 603
Minneapolis, MN 55414-3950

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
11015ZZMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1164918009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 13TH AVE SE APT 603",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDIN",
        "first_name": "ANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "ZZ",
            "license": "11015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.