Individual provider Active NPI

Laura S. Collier, D.D.S.

  • Dentist
  • Excelsior, MN
National Provider Identifier
1720049570
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11680 Issued in MN
Practice address
348 2ND Street, Suite #200
Excelsior, MN 55331
Phone
(952) 474-6515
Fax
(952) 474-1206
NPI assigned
Mar 31, 2006
Last updated
Dec 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11680 MN Primary

Addresses

Primary practice location

348 2ND Street, Suite #200
Excelsior, MN 55331

Mailing address

348 2ND Street Suite #200
Excelsior, MN 55331
Phone (952) 474-6515

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170912002943 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4981977071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11680MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Family Dental 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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1720049570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 2ND STREET SUITE #200",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "55331",
            "telephone_number": "952-474-6515",
            "fax_number": "952-474-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 2ND STREET, SUITE #200",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "55331",
            "telephone_number": "952-474-6515",
            "fax_number": "952-474-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "LAURA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior, MN

Sources for this page

Verify at the official NPI Registry.