Individual provider Active NPI

Alexander Joseph Sahyouni, DMD

  • Dentist
  • Alexandria, MN
National Provider Identifier
1346707007
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14840 Issued in MN
Practice address
1400 Hawthorne St Ste 2
Alexandria, MN 56308-4550
Phone
(320) 762-2122
NPI assigned
Feb 28, 2019
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14840 MN Primary
Dentist 122300000X 1002057 WI
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1400 Hawthorne St Ste 2
Alexandria, MN 56308-4550

Mailing address

1400 Hawthorne St Ste 2
Alexandria, MN 56308-4550
Phone (320) 762-2122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190814001367 WI Order and Referring Only - DentistPractitioner - Dentist 1456688449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14840MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sahyouni Dental, PLLC CurrentSince Dec 10, 2023 Accepting new patients
Dean R. Anderson DDS PC PastSince Dec 10, 2023 Accepting new patients

Locations

1400 Hawthorne St
Ste 2
Alexandria, MN 56308
Phone (320) 762-2122

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1346707007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HAWTHORNE ST STE 2",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084550",
            "telephone_number": "320-762-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HAWTHORNE ST STE 2",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084550",
            "telephone_number": "320-762-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHYOUNI",
        "first_name": "ALEXANDER",
        "middle_name": "JOSEPH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14840",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002057",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.