Active NPI
Sophana Jayakumar, MDS, DDS
- Dentist
- Coon Rapids, MN
National Provider Identifier
1760364111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15323
- Practice address
- 11237 Foley Blvd NW
Coon Rapids, MN 55448-3389 - Phone
- (763) 757-1234
- NPI assigned
- Jul 24, 2025
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 15323 | MN | Primary |
Addresses
Primary practice location
11237 Foley Blvd NW
Coon Rapids, MN 55448-3389
Mailing address
19984 62ND PL
Corcoran, MN 55340
Phone (612) 986-7544
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1760364111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19984 62ND PL",
"city": "CORCORAN",
"state": "MN",
"postal_code": "55340",
"telephone_number": "612-986-7544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11237 FOLEY BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554483389",
"telephone_number": "763-757-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYAKUMAR",
"first_name": "SOPHANA",
"credential": "MDS, DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-24",
"last_updated": "2025-07-24",
"certification_date": "2025-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "15323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.