Individual provider Active NPI

Kara A Engelbrektson, DDS

  • Dentist
  • Sartell, MN
National Provider Identifier
1629398532
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12820 Issued in MN
Practice address
2251 Connecticut Ave S
Sartell, MN 56377-4772
Phone
(320) 253-5824
NPI assigned
Jun 3, 2010
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12820 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X UNKNOWN MN

Addresses

Primary practice location

2251 Connecticut Ave S
Sartell, MN 56377-4772

Mailing address

2251 Connecticut Ave S
Sartell, MN 56337-4772
Phone (320) 253-5824

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
I20120124000724 MN Practitioner - Oral Surgery 7416124987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
UNKNOWNMNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Oct 1, 2011 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. Dentist CurrentSince Oct 1, 2011 Accepting new patients

Locations

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

2251 Connecticut Ave S
Sartell, MN 56377
Phone (320) 253-5220

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1629398532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563374772",
            "telephone_number": "320-253-5824",
            "fax_number": "320-203-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774772",
            "telephone_number": "320-253-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELBREKTSON",
        "first_name": "KARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12820",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "UNKNOWN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.