Individual provider Active NPI

Elizabeth Lowe Robinson Phillips, DDS

  • Dentist
  • Minnetonka, MN
National Provider Identifier
1669544029
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11571 Issued in MN
Practice address
11601 Minnetonka Mills Rd
Minnetonka, MN 55305-5161
Phone
(952) 938-8533
NPI assigned
Nov 14, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11571 MN Primary

Addresses

Primary practice location

11601 Minnetonka Mills Rd
Minnetonka, MN 55305-5161

Mailing address

6929 Autumn Ter
Eden Prairie, MN 55346-3310
Phone (952) 217-5238

Other identifiers 1

IdentifierTypeStateIssuer
11571OtherMNSTATE DENTAL LICENSE

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615002113 MN Order and Referring Only - Nurse Practitioner 6608187836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11571MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tonka Smiles Dentist Past Accepting new patients

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669544029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6929 AUTUMN TER",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553463310",
            "telephone_number": "952-217-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 MINNETONKA MILLS RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055161",
            "telephone_number": "952-938-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ELIZABETH",
        "middle_name": "LOWE ROBINSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "11571",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.