Active NPI
Tiffany Lynn Nelson, DDS
- Dentist
- Duluth, MN
National Provider Identifier
1275727000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14107
- Practice address
- 320 West Myrtle St
Ste 100
Duluth, MN 55811 - Phone
- (218) 491-8058
- NPI assigned
- Sep 5, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14107 | MN | Primary |
Addresses
Primary practice location
320 West Myrtle St
Ste 100
Duluth, MN 55811
Mailing address
4325 Grand Ave
Apt 308
Duluth, MN 55807-2730
Phone (218) 628-7035
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14107 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1275727000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4325 GRAND AVE",
"address_2": "APT 308",
"city": "DULUTH",
"state": "MN",
"postal_code": "558072730",
"telephone_number": "218-628-7035",
"fax_number": "218-624-6594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 WEST MYRTLE ST",
"address_2": "STE 100",
"city": "DULUTH",
"state": "MN",
"postal_code": "55811",
"telephone_number": "218-491-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "TIFFANY",
"middle_name": "LYNN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "14107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.