Individual provider Active NPI

Taylor M Heinlein, DDS

  • General Practice Dentistry
  • Columbia Heights, MN
National Provider Identifier
1831685072
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14083 Issued in MN
Practice address
5207 University Ave NE
Columbia Heights, MN 55421-1649
Phone
(763) 572-8040
NPI assigned
Jul 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14083 MN Primary

Addresses

Primary practice location

5207 University Ave NE
Columbia Heights, MN 55421-1649

Mailing address

5207 University Ave NE
Columbia Heights, MN 55421-1649
Phone (763) 572-8040

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

LicenseStateTypeSpecialty
D14083MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Heinlein DDS PA CurrentSince Jan 8, 2023 Accepting new patients
Ascent Family Dentistry General Practice Past Accepting new patients

Locations

5207 University Ave NE
Minneapolis, MN 55421
Phone (763) 572-8040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1831685072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 UNIVERSITY AVE NE",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554211649",
            "telephone_number": "763-572-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 UNIVERSITY AVE NE",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554211649",
            "telephone_number": "763-572-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINLEIN",
        "first_name": "TAYLOR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.