Individual provider Active NPI

Amanda Helgerson De Los Rios, DDS

  • Dentist
  • Lakeville, MN
National Provider Identifier
1346807666
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14211 Issued in MN
Practice address
16372 Kenrick Ave
Lakeville, MN 55044-3540
Phone
(952) 435-5905
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14211 MN Primary

Addresses

Primary practice location

16372 Kenrick Ave
Lakeville, MN 55044-3540

Mailing address

16372 Kenrick Ave
Lakeville, MN 55044-3540
Phone (952) 435-5905

Other names 1

  • Amanda Marie Helgerson Former name

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
D14211MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1346807666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443540",
            "telephone_number": "952-435-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16372 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443540",
            "telephone_number": "952-435-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS RIOS",
        "first_name": "AMANDA",
        "middle_name": "HELGERSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HELGERSON",
            "middle_name": "MARIE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.