Individual provider Active NPI

Hidayo Elmi, DDS

  • General Practice Dentistry
  • West St Paul, MN
National Provider Identifier
1497258982
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14029 Issued in MN
Practice address
1200 Robert St S Ste C
West St Paul, MN 55118-2322
Phone
(952) 564-0339
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14029 MN Primary

Addresses

Primary practice location

1200 Robert St S Ste C
West St Paul, MN 55118-2322

Mailing address

1200 Robert St S Ste C
West St Paul, MN 55118-2322
Phone (952) 564-0339

Other practice location 1

606 24th Ave S Ste 200
Minneapolis, MN 55454
Phone (612) 659-8689

Other practice location 2

8454 Highway 7
St Louis Park, MN 55426-3900
Phone (952) 933-3667

Other practice location 3

1700 Highway 36 W Ste 860
Roseville, MN 55113
Phone (651) 778-9911

Other practice location 4

675 E Nicollet Blvd Ste 120
Burnsville, MN 55337-6748
Phone (612) 843-2951

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
D14029MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Home Health LLC Current Accepting new patients
All About Dentistry General Practice Current Accepting new patients
Knollwood Dentistry, PC General Practice Past Accepting new patients

Locations

675 E Nicollet Blvd
Ste 120
Burnsville, MN 55337
Phone (612) 843-2951

1200 Robert St S
Ste C
West St Paul, MN 55118
Phone (651) 340-9151

Organizations & group practices 3

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1497258982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROBERT ST S STE C",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551182322",
            "telephone_number": "952-564-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROBERT ST S STE C",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551182322",
            "telephone_number": "952-564-0339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 24th Ave S Ste 200",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55454",
            "country_code": "US",
            "telephone_number": "612-659-8689",
            "fax_number": "612-659-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8454 Highway 7",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554263900",
            "country_code": "US",
            "telephone_number": "952-933-3667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Highway 36 W Ste 860",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "55113",
            "country_code": "US",
            "telephone_number": "651-778-9911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 E Nicollet Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553376748",
            "country_code": "US",
            "telephone_number": "612-843-2951",
            "fax_number": "612-843-2889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMI",
        "first_name": "HIDAYO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.