Individual provider Active NPI

Alena Marie Harris Martens, D.D.S

  • General Practice Dentistry
  • Maplewood, MN
National Provider Identifier
1295908994
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12297 Issued in MN
Practice address
1650 Beam Ave Ste 103
Maplewood, MN 55109-1147
Phone
(651) 770-7175
Fax
(651) 770-6109
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12297 MN Primary

Addresses

Primary practice location

1650 Beam Ave Ste 103
Maplewood, MN 55109-1147

Mailing address

412 Elm St W
Stillwater, MN 55082-4415
Phone (651) 323-7488

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
D12297MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1295908994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 ELM ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824415",
            "telephone_number": "651-323-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 BEAM AVE STE 103",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091147",
            "telephone_number": "651-770-7175",
            "fax_number": "651-770-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "ALENA",
        "middle_name": "MARIE HARRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.