Kassidy Steen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15153 Issued in MN

Practice address

1384 109TH Ave NE Ste 200
Blaine, MN 55434-4543

Phone

(763) 757-6000

NPI assigned

Jul 11, 2024

Last updated

Jul 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

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.

• Blaine Dentistry, PC

  dba Blaine Dentistry

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1982007803
  NPD (past)

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1790522191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 FREMONT AVE S APT 216",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082089",
            "telephone_number": "763-757-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 109TH AVE NE STE 200",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344543",
            "telephone_number": "763-757-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEEN",
        "first_name": "KASSIDY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soul Work Counseling, LLC
• Jennifer Soular
• Tracy Spitzack, SLP
• St. Croix Endodontics
• St. Croix Endodontics, P.a.
• Ana Paulina Arias Bello Steffer, MA, LADC
• Robert B Stein
• Courtney Ann Steuber, RN
• Steve's Transportation LLC
• Rebecca Ann Stewart, PHARMD

• General Practice Dentistry in Blaine, MN
• Providers in Blaine, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.