Active NPI
Shelly Stecker
- Dentist
- Saint Paul, MN
National Provider Identifier
1336119650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D11462
- Practice address
- 828 Hawthorne St E
Saint Paul, MN 55106-3252 - Phone
- (651) 774-2959
- NPI assigned
- Jan 26, 2006
- 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 | D11462 | MN | Primary |
Addresses
Primary practice location
828 Hawthorne St E
Saint Paul, MN 55106-3252
Mailing address
4308 Arthur St NE
Columbia Heights, MN 55421-3237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160314000207 | MN | Order and Referring Only - Dentist | 4587960877 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1336119650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4308 ARTHUR ST NE",
"city": "COLUMBIA HEIGHTS",
"state": "MN",
"postal_code": "554213237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 HAWTHORNE ST E",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551063252",
"telephone_number": "651-774-2959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STECKER",
"first_name": "SHELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D11462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.