Abdulkadir Egeh, DT

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT125 Issued in MN

Practice address

636 Broadway St NE
Minneapolis, MN 55413-2164

Phone

(612) 746-1530

Fax

(612) 746-1531

NPI assigned

Aug 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children'S Dental Services

  • Public Health Dentistry
  • Chisholm, MN
  • NPI 1669842662
  NPD (past)
• Childrens Dental Services Inc

  • Public Health Dentistry
  • Minneapolis, MN
  • NPI 1407973605
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1568074607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14430 WOODBRIDGE LN",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782825",
            "telephone_number": "612-998-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132164",
            "telephone_number": "612-746-1530",
            "fax_number": "612-746-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGEH",
        "first_name": "ABDULKADIR",
        "credential": "DT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Minneapolis",
            "affiliation": "N",
            "address_1": "636 Broadway St NE",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554132164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Patrick Egan, L.AC.
• Olivia Rhett Hill Egan
• Ryan Patrick Egan, MA
• Elizabeth Egbert, PSY.D., LP
• Cajetan Chukwuma Egbujor, LICSW
• Lindsey Sarah Egeler, MT-BC
• Terri L Egesdahl, RN-FA
• Kathryn Egge, LMFT
• Joshua Timothy Eggebraaten, DDS
• Emily L Eggebrecht Pietig, D.D.S.

• Dental Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.