Andrew Akhaphong, RD, LD – Registered Dietitian

Key facts

NPI: 1356792444
Entity type: Individual (NPI type 1)
Primary specialty: Registered Dietitian 133V00000X
License: 3431 (MN)
Practice address: 851 Marketplace Dr
Waconia, MN 55387-1548
Phone: (952) 442-2512
Fax: (952) 442-4221
NPI assigned: Jun 29, 2016
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Mackenthun Supermarkets, Inc. Registered Dietitian · Waconia, MN · NPI 1750963088

NPD DIETITIAN, REGISTERED

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
3431	MN	MD	Marriage & Family Therapist

Practice roles

Organization	Specialty	Status	New patients
Mackenthun Supermarkets, Inc.	Dietitian, Registered	Current	Accepting new patients

Locations

851 Marketplace Dr
Waconia, MN 55387
Phone (952) 442-2512

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian	133V00000X	3431	MN	Yes

Addresses

Primary practice location

851 Marketplace Dr
Waconia, MN 55387-1548

Mailing address

1046 Aston Cir
Burnsville, MN 55337-6716
Phone (952) 232-8409

Other providers in Waconia, MN

All providers in Waconia, MN · Registered Dietitian in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.