Active NPI
Annie Marie Lutterman, RDH
- Dental Hygienist
- Woodbury, MN
National Provider Identifier
1578897328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H8020
- Practice address
- 1789 Woodlane Drive
Suite D
Woodbury, MN 55125 - Phone
- (651) 738-1284
- NPI assigned
- Sep 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H8020 | MN | Primary |
Addresses
Primary practice location
1789 Woodlane Drive
Suite D
Woodbury, MN 55125
Mailing address
1789 Woodlane Drive
Suite D
Woodbury, MN 55125
Phone (651) 738-1284
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
| License | State | Type | Specialty |
|---|---|---|---|
| H8020 | MN | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodgrove Dental PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Woodbury, MN
- NPI 1356539993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254096000000",
"number": "1578897328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1789 WOODLANE DRIVE",
"address_2": "SUITE D",
"city": "WOODBURY",
"state": "MN",
"postal_code": "55125",
"telephone_number": "651-738-1284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 WOODLANE DRIVE",
"address_2": "SUITE D",
"city": "WOODBURY",
"state": "MN",
"postal_code": "55125",
"telephone_number": "651-738-1284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTERMAN",
"first_name": "ANNIE",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-28",
"last_updated": "2009-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MN",
"license": "H8020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.