Elmi Abdulkadir Elmi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14524 Issued in MN

Practice address

1200 Robert St S Ste C
West St Paul, MN 55118-2322

Phone

(651) 340-9151

NPI assigned

May 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1861014235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROBERT ST S STE C",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551182322",
            "telephone_number": "651-340-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROBERT ST S STE C",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551182322",
            "telephone_number": "651-340-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 E Nicollet Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553376748",
            "country_code": "US",
            "telephone_number": "612-843-2951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMI",
        "first_name": "ELMI",
        "middle_name": "ABDULKADIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Deziel
• Heidi Jean Diekmann, DDS
• Dignified Living Health Services LLC
• Divine Redeemer Mobile Meals
• Ross Ducept, REGISTERED PHARMACIS
• Hidayo Elmi, DDS
• Adam Reed Elwood, MS, LPCC, LMHC
• Evernear Care Corp.
• Raymond John Fabian Jr., PTA
• Family Healthservices Minnesota, P.a.

• General Practice Dentistry in West St Paul, MN
• Providers in West St Paul, 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 Jun 2, 2025; 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.