Active NPI
Teresa Nguyen
- Dental Therapist
- Maple Grove, MN
National Provider Identifier
1689512014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT198
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| H10972 | MN | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PL Dental SC | Past | Accepting new patients | |
| PL Dental SC | Past | Accepting new patients | |
| Dental Delivery Systems of Maple Grove LLC | Past | 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.
-
- General Practice Dentistry
- Maple Grove, MN
- NPI 1760272611
-
- Dental Clinic/Center
- Zimmerman, MN
- NPI 1225786411
-
- Dental Clinic/Center
- Coon Rapids, MN
- NPI 1952140691
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.