Individual provider Active NPI

Dorothy Cheng, PHARMD

  • Pharmacist
  • Crystal, MN
National Provider Identifier
1366047102
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
124720 Issued in MN
Practice address
5537 W Broadway Ave
Crystal, MN 55428-3507
Phone
(763) 533-1651
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 124720 MN Primary

Addresses

Primary practice location

5537 W Broadway Ave
Crystal, MN 55428-3507

Mailing address

1920 S 1St St Apt 1202
Minneapolis, MN 55454-1199
Phone (734) 395-3798

Other practice location 1

300 Clydesdale Trl
Medina, MN 55340-4538
Phone (763) 852-0007

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
124720MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand St Paul CVS LLC Past Accepting new patients
Grand St Paul CVS LLC Past Accepting new patients

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1366047102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 S 1ST ST APT 1202",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541199",
            "telephone_number": "734-395-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283507",
            "telephone_number": "763-533-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Clydesdale Trl",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "MN",
            "postal_code": "553404538",
            "country_code": "US",
            "telephone_number": "763-852-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENG",
        "first_name": "DOROTHY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "124720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.