Individual provider Active NPI

Andree-Maude Dubois Lebel, DMD

  • Pediatric Dentistry
  • Brooklyn Center, MN
National Provider Identifier
1629277330
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D12885 Issued in MN
Practice address
5901 John Martin Dr
Brooklyn Center, MN 55430-2509
Phone
(763) 585-8700
NPI assigned
Jul 12, 2007
Last updated
Sep 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D12885 MN Primary

Addresses

Primary practice location

5901 John Martin Dr
Brooklyn Center, MN 55430-2509

Mailing address

1850 Terraceview LN N
Apt. a
Plymouth, MN 55447-6503
Phone (651) 600-8019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000685 MN Practitioner - Oral Surgery 9032381934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Sep 26, 2011 Accepting new patients
Group Health, Inc. Pediatric Dentistry CurrentSince Sep 26, 2011 Accepting new patients

Locations

5901 John Martin Dr
Minneapolis, MN 55430
Phone (763) 566-3770

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1629277330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 TERRACEVIEW LN N",
            "address_2": "APT. A",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554476503",
            "telephone_number": "651-600-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 JOHN MARTIN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302509",
            "telephone_number": "763-585-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS LEBEL",
        "first_name": "ANDREE-MAUDE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D12885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.