Emily Marie Allen
Individual provider Active NPI Dentist · Chaska, MN
NPI 1508350299 · NPPES record last updated Jul 8, 2019
Key facts
- NPI
- 1508350299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D14050 (MN)
- Practice address
- 114 Pioneer TRL
Chaska, MN 55318-1167 - Phone
- (952) 361-6855
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180925000610 | MN | Order and Referring Only - Dentist |
8123379526 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chaska Commons Dental Group PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D14050 | MN | Yes |
Addresses
Primary practice location
114 Pioneer TRL
Chaska, MN 55318-1167
Mailing address
2510 Bantas Point LN
Wayzata, MN 55391-2306
Phone (952) 250-3698
Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.