Nadine Yacoub, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14016 Issued in MN

Practice address

3930 Northwoods Dr
Arden Hills, MN 55112

Phone

(651) 523-8585

NPI assigned

May 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health Plan, Inc

  • General Practice Dentistry
  • Sartell, MN
  • NPI 1538213566
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1730679325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 NORTHWOODS DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551126963",
            "telephone_number": "651-523-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 NORTHWOODS DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-523-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 W 36th St Ste 250",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162776",
            "country_code": "US",
            "telephone_number": "763-913-4691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 W 36th St Ste 250",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162776",
            "country_code": "US",
            "telephone_number": "763-913-4691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5901 John Martin Dr",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554302509",
            "country_code": "US",
            "telephone_number": "763-585-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "NADINE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eleana M Yang
• Kimberly Yang
• Nou Chee Yang

• Dentist in Arden Hills, MN
• Providers in Arden Hills, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.