Active NPI
Kayla Dawn Hanninen, DMD
- Dentist
- Excelsior, MN
National Provider Identifier
1659865822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14045
- Practice address
- 6140 Lake Linden Dr
Excelsior, MN 55331-2954 - Phone
- (952) 474-4123
- NPI assigned
- Jun 20, 2018
- 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 | D14045 | MN | Primary |
Addresses
Primary practice location
6140 Lake Linden Dr
Excelsior, MN 55331-2954
Mailing address
305 Pondview LN
Chaska, MN 55318-2873
Phone (952) 297-5515
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 |
|---|---|---|---|
| D14045 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1659865822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 PONDVIEW LN",
"city": "CHASKA",
"state": "MN",
"postal_code": "553182873",
"telephone_number": "952-297-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 LAKE LINDEN DR",
"city": "EXCELSIOR",
"state": "MN",
"postal_code": "553312954",
"telephone_number": "952-474-4123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNINEN",
"first_name": "KAYLA",
"middle_name": "DAWN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-20",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Excelsior, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.