Individual provider Active NPI

Claudia De Llano, D.D.S.

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1376669895
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11648 Issued in MN
Practice address
4520 Centerville Rd
Saint Paul, MN 55127-3602
Phone
(651) 426-4799
Fax
(651) 426-8106
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11648 MN Primary

Addresses

Primary practice location

4520 Centerville Rd
Saint Paul, MN 55127-3602

Mailing address

4520 Centerville Rd
Saint Paul, MN 55127-3602
Phone (651) 426-4799

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
I20150805008237 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4789998634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376669895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 CENTERVILLE RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551273602",
            "telephone_number": "651-426-4799",
            "fax_number": "651-426-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 CENTERVILLE RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551273602",
            "telephone_number": "651-426-4799",
            "fax_number": "651-426-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LLANO",
        "first_name": "CLAUDIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.