Individual provider Active NPI

Madalyn Suzanne Duplessis, DMD

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1386146512
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14143 Issued in MN
Practice address
2442 Mounds View Blvd
Saint Paul, MN 55112-1478
Phone
(763) 316-5400
NPI assigned
Mar 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X D14143 MN Primary

Addresses

Primary practice location

2442 Mounds View Blvd
Saint Paul, MN 55112-1478

Mailing address

2442 Mounds View Blvd
Saint Paul, MN 55112-1478
Phone (763) 316-5400

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

LicenseStateTypeSpecialty
D14143MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1386146512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 MOUNDS VIEW BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551121478",
            "telephone_number": "763-316-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 MOUNDS VIEW BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551121478",
            "telephone_number": "763-316-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPLESSIS",
        "first_name": "MADALYN",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-04",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.