Active NPI
Taylor Rose Leos, DDS
- Student in an Organized Health Care Education/Training Program
- Minneapolis, MN
National Provider Identifier
1841992989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- R886
- Practice address
- 515 Delaware St SE
Minneapolis, MN 55455-0357 - Phone
- (512) 663-5955
- NPI assigned
- Mar 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R886 | MN | Primary |
| Dentist | 122300000X | DDS-10095 | IA |
Addresses
Primary practice location
515 Delaware St SE
Minneapolis, MN 55455-0357
Mailing address
515 Delaware St SE
Minneapolis, MN 55455-0357
Phone (512) 663-5955
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 |
|---|---|---|---|
| DDS-10095 | IA | MD | Dentist |
| R886 | MN | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1841992989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 DELAWARE ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550357",
"telephone_number": "512-663-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 DELAWARE ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550357",
"telephone_number": "512-663-5955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEOS",
"first_name": "TAYLOR",
"middle_name": "ROSE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-21",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MN",
"license": "R886",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-10095",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.