Active NPI
Leah Loehndorf, MDT
- Dental Therapist
- Saint Cloud, MN
National Provider Identifier
1245687821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT54
- Practice address
- 4128 2ND St S
Saint Cloud, MN 56301-3704 - Phone
- (320) 774-2556
- Fax
- (320) 774-2559
- NPI assigned
- May 24, 2016
- Last updated
- May 24, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DT54 | MN | Primary |
Addresses
Primary practice location
4128 2ND St S
Saint Cloud, MN 56301-3704
Mailing address
13301 Maple Knoll Way
Apt 1705
Maple Grove, MN 55369-5006
Phone (414) 651-1000
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 |
|---|---|---|---|
| DT54 | MN | MD | Dental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1245687821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13301 MAPLE KNOLL WAY",
"address_2": "APT 1705",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553695006",
"telephone_number": "414-651-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4128 2ND ST S",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563013704",
"telephone_number": "320-774-2556",
"fax_number": "320-774-2559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOEHNDORF",
"first_name": "LEAH",
"credential": "MDT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-24",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT54",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.