Alexa Nicole Weiss, LDH
Individual provider Active NPI Dental Therapist · Springfield, MN
NPI 1255084166 · NPPES record last updated Jun 28, 2022
Key facts
- NPI
- 1255084166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Therapist 125J00000X
- License
- DT145 (MN)
- Practice address
- 602 N Jackson Ave
Springfield, MN 56087-4502 - Phone
- (507) 723-4375
- NPI assigned
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H11217 | MN | MD | Dental Hygienist |
| DT145 | MN | MD | Dental Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H11217 | MN | |
| Dental Therapist | 125J00000X | DT145 | MN | Yes |
Addresses
Primary practice location
602 N Jackson Ave
Springfield, MN 56087-4502
Mailing address
602 N Jackson Ave
Springfield, MN 56087-4502
Phone (507) 723-4375
Other providers in Springfield, MN
- Joyce Tarbet
- Jenna Leigh Tews
- Thrifty Drug Stores Inc
- Christina Marie Vogel
- Melissa Sue Wegscheid
- Jennifer White
All providers in Springfield, MN · Dental Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.