Active NPI
Hilary Megan Mayne, DDS
- Dentist
- Minnetonka, MN
National Provider Identifier
1235417783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12994
- Practice address
- 13059 Ridgedale Dr
Minnetonka, MN 55305-1807 - Phone
- (952) 545-8603
- NPI assigned
- Aug 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6766-015 | WI | |
| Dentist | 122300000X | D12994 | MN | Primary |
Addresses
Primary practice location
13059 Ridgedale Dr
Minnetonka, MN 55305-1807
Mailing address
2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815
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
| License | State | Type | Specialty |
|---|---|---|---|
| D12994 | MN | MD | Dentist |
| 6766-015 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Facial Pain Center PLLC | Dentist | Past | Accepting new patients |
| PDG,P.a. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1235417783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 COUNTY ROAD C W STE 2210",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551132551",
"telephone_number": "651-746-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13059 RIDGEDALE DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553051807",
"telephone_number": "952-545-8603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNE",
"first_name": "HILARY",
"middle_name": "MEGAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6766-015",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D12994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.