Individual provider Active NPI

Lois J Kehl, DDS

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1356433346
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10160 Issued in MN
Practice address
2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052
Phone
(651) 332-7474
Fax
(651) 332-7475
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10160 MN Primary

Addresses

Primary practice location

2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052

Mailing address

2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052
Phone (651) 332-7474

Other identifiers 4

IdentifierTypeStateIssuer
24A16KEOtherMNBLUE CROSS
296025700MedicaidMN
43-41300OtherMNMEDICA
1011992OtherMNPREFERRED ONE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL athenanet Health Information Exchange (HIE)

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000901 MN Practitioner - Oral Surgery 3173653797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Head and Neck Pain Clinic PAGroup PAC ID 2769453687, 18 clinicians

Practice addresses (Care Compare)

2550 University Ave W
Suite 189S
Saint Paul, MN 55114-2001
Phone (651) 332-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10160MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Nov 25, 1996 Accepting new patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Nov 25, 1996 Accepting new patients

Locations

3475 Plymouth Blvd
Ste 200
Plymouth, MN 55447
Phone (763) 577-2484

2550 University Ave W
Ste 189S
Saint Paul, MN 55114
Phone (651) 332-7474

Interoperability endpoints

  • Direct secure messaging: lois.kehl.1@13597.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1356433346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 189S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-332-7474",
            "fax_number": "651-332-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 189S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-332-7474",
            "fax_number": "651-332-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHL",
        "first_name": "LOIS",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "24A16KE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296025700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "43-41300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1011992",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "athenanet",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "electronic health record",
            "address_1": "2550 University Ave W",
            "address_2": "Suite 189S",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551141052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.