Individual provider Active NPI

Allison Vanlaecken-Heggelund

  • Dentist
  • Watertown, SD
National Provider Identifier
1710676747
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D1393 Issued in SD
Practice address
1190 S Lake Dr
Watertown, SD 57201-5447
Phone
(605) 954-8396
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 D1393 SD Primary

Addresses

Primary practice location

1190 S Lake Dr
Watertown, SD 57201-5447

Mailing address

1190 S Lake Dr
Watertown, SD 57201-5447
Phone (605) 954-8396

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
D1393SDMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1710676747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 S LAKE DR",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015447",
            "telephone_number": "605-954-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 S LAKE DR",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015447",
            "telephone_number": "605-954-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLAECKEN-HEGGELUND",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D1393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.