Individual provider Active NPI

Mary Kay Dunham

  • Speech-Language Pathologist
  • Plymouth, MN
National Provider Identifier
1669301685
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
314762 Issued in MN
Practice address
13305 12TH Ave N
Plymouth, MN 55441-4527
Phone
(763) 745-5246
NPI assigned
May 15, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 314762 MN Primary

Addresses

Primary practice location

13305 12TH Ave N
Plymouth, MN 55441-4527

Mailing address

13305 12TH Ave N
Plymouth, MN 55441-4527
Phone (763) 745-5246

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

LicenseStateTypeSpecialty
314762MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1669301685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 12TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414527",
            "telephone_number": "763-745-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 12TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414527",
            "telephone_number": "763-745-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "MARY",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "314762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.