Active NPI
Jenny Kohler
- Dental Assistant
- Stillwater, MN
National Provider Identifier
1376798173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- A12760
- Practice address
- 1407 6TH St S
Stillwater, MN 55082-5707 - Phone
- (651) 428-4477
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | A12760 | MN | Primary |
Addresses
Primary practice location
1407 6TH St S
Stillwater, MN 55082-5707
Mailing address
1407 6TH St S
Stillwater, MN 55082-5707
Phone (651) 428-4477
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
| License | State | Type | Specialty |
|---|---|---|---|
| A12760 | MN | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1376798173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 6TH ST S",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550825707",
"telephone_number": "651-428-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 6TH ST S",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550825707",
"telephone_number": "651-428-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLER",
"first_name": "JENNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "MN",
"license": "A12760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.