Individual provider Active NPI

Lauren Kristine Phipps, D.D.S.

  • Dentist
  • Albertville, MN
National Provider Identifier
1801270301
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D13598 Issued in MN
Practice address
5585 La Centre Ave Ste 500
Albertville, MN 55301-4686
Phone
(763) 497-7730
NPI assigned
Jul 14, 2015
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13598 MN Primary

Addresses

Primary practice location

5585 La Centre Ave Ste 500
Albertville, MN 55301-4686

Mailing address

5585 Lacentre Ave
Suite 500
Albertville, MN 55301
Phone (763) 497-7730

Other practice location 1

823 N Broadway St
Spring Valley, MN 55975
Phone (507) 287-8320

Other identifiers 1

IdentifierTypeStateIssuer
D13598OtherMNMINNESOTA BOARD OF DENTISTRY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111000319 MN Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - General Practice 4587974142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Dental Dentist PastSince Jan 12, 2020 Accepting new patients
Spring Valley Dental Past Accepting new patients

Organizations & group practices 2

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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1801270301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5585 LACENTRE AVE",
            "address_2": "SUITE 500",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "55301",
            "telephone_number": "763-497-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5585 LA CENTRE AVE STE 500",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553014686",
            "telephone_number": "763-497-7730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "MN",
            "postal_code": "55975",
            "country_code": "US",
            "telephone_number": "507-287-8320",
            "fax_number": "507-281-8757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "LAUREN",
        "middle_name": "KRISTINE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF DENTISTRY",
            "identifier": "D13598",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albertville, MN

Sources for this page

Verify at the official NPI Registry.