Alyssa Klugman, ADT, LDH

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT133 Issued in MN

Practice address

327 Western Ave Ste a
Fergus Falls, MN 56537-2403

Phone

(218) 998-2218

NPI assigned

Jun 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alyssa Buckhouse Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1568088466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 WESTERN AVE STE A",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372403",
            "telephone_number": "218-998-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 WESTERN AVE STE A",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372403",
            "telephone_number": "218-998-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUGMAN",
        "first_name": "ALYSSA",
        "credential": "ADT, LDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H9901",
            "primary": false
        },
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "BUCKHOUSE",
            "credential": "ADT, LDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Kingston, D,D,S,, M.S.
• Shirley J Kirk, RN
• Christopher Michael Kjolhaug, PT
• Jacquelin Lee Klinnert, RN
• Raegan Klosterman
• Laura Diane Knopp, MSW, LICSW
• Samantha Jo Knudson
• Mary Knutson
• Natalie Knutson
• Melissa Koehl, NP

• Dental Therapist in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.