Active NPI
Emily Rae Dickinsen, DT
- Dental Therapist
- Savage, MN
National Provider Identifier
1780257212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT140
- Practice address
- 14393 Hwy 13 S
Savage, MN 55378-2153 - Phone
- (952) 440-2292
- Fax
- (952) 440-2935
- NPI assigned
- Jul 22, 2021
- 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 | DT140 | MN | Primary |
Addresses
Primary practice location
14393 Hwy 13 S
Savage, MN 55378-2153
Mailing address
14393 Hwy 13 S
Savage, MN 55378-2153
Phone (952) 440-2292
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 |
|---|---|---|---|
| DT140 | MN | MD | Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDB, DDS, PA | 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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Maple Grove, MN
- NPI 1942809637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1780257212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14393 HWY 13 S",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553782153",
"telephone_number": "952-440-2292",
"fax_number": "952-440-2935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14393 HWY 13 S",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553782153",
"telephone_number": "952-440-2292",
"fax_number": "952-440-2935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKINSEN",
"first_name": "EMILY",
"middle_name": "RAE",
"name_prefix": "Miss",
"credential": "DT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savage, MN
- Dentists of Savage, PC (Dentists of Savage)
- Designing Dreams by Loramy Inc
- Alberta Winnifred Desouza Addo
- Diamond Care Limited Liability Company
- Laura Jean Dickason-Sopeth, OTR
- Salma A Diini
- Michelle Dineen, LICSW
- Discovery Home Care Inc.
- Mahawa Jamila Doumbouya, MHP
- Dr. Sharon Mahowald-Horner, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.