Individual provider Active NPI

Jennicca Ann Leier, DDS

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1669367652
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D15297 Issued in MN
Practice address
1371 7TH St W
Saint Paul, MN 55102-4297
Phone
(651) 359-9889
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D15297 MN Primary

Addresses

Primary practice location

1371 7TH St W
Saint Paul, MN 55102-4297

Mailing address

18785 160TH Ave NW
Thief River Falls, MN 56701-8834
Phone (218) 688-2059

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
D15297MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1669367652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18785 160TH AVE NW",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567018834",
            "telephone_number": "218-688-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024297",
            "telephone_number": "651-359-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIER",
        "first_name": "JENNICCA",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D15297",
            "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 Jun 10, 2025; 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.