Individual provider Active NPI

Teresa Nguyen

  • Dental Therapist
  • Maple Grove, MN
National Provider Identifier
1689512014
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental TherapistTaxonomy code 125J00000X
License
DT198 Issued in MN
Practice address
9400 Upland LN N
Maple Grove, MN 55369-4464
Phone
(763) 363-0063
Fax
(763) 363-3321
NPI assigned
Mar 24, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X DT198 MN Primary

Addresses

Primary practice location

9400 Upland LN N
Maple Grove, MN 55369-4464

Mailing address

12605 Fergus St NE
Blaine, MN 55449-3905

Other practice location 1

9920 Foley Blvd NW Ste 110
Coon Rapids, MN 55433-5216
Phone (763) 317-1166

Other practice location 2

1790 7th St E
Saint Paul, MN 55119-3419
Phone (651) 735-0595

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
H10972MNMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
PL Dental SC PastSince Mar 1, 2022 Accepting new patients
PL Dental SC PastSince May 26, 2024 Accepting new patients
Dental Delivery Systems of Maple Grove LLC PastSince May 18, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1689512014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12605 FERGUS ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 UPLAND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694464",
            "telephone_number": "763-363-0063",
            "fax_number": "763-363-3321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9920 Foley Blvd NW Ste 110",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335216",
            "country_code": "US",
            "telephone_number": "763-317-1166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1790 7th St E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551193419",
            "country_code": "US",
            "telephone_number": "651-735-0595",
            "fax_number": "651-735-0521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.