Active NPI
Hannah E Juettner
- Dentist
- Saint Paul, MN
National Provider Identifier
1619502960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14613
- Practice address
- 1736 Cope Ave E
Saint Paul, MN 55109-2610 - Phone
- (651) 770-3831
- NPI assigned
- Mar 6, 2020
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14613 | MN | Primary |
Addresses
Primary practice location
1736 Cope Ave E
Saint Paul, MN 55109-2610
Mailing address
601 Menaul Blvd NE Unit 702
Albuquerque, NM 87107-1564
Phone (502) 645-3317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201019000620 | NM | Order and Referring Only - Dentist | 2860812518 | |
| I20210901003752 | MN | Order and Referring Only - Dentist | 2860812518 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14613 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1619502960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 MENAUL BLVD NE UNIT 702",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071564",
"telephone_number": "502-645-3317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1736 COPE AVE E",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551092610",
"telephone_number": "651-770-3831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUETTNER",
"first_name": "HANNAH",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-06",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "14613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.