Individual provider Active NPI

Kelsey Marben

  • Dental Therapist
  • Mankato, MN
National Provider Identifier
1861374449
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental TherapistTaxonomy code 125J00000X
License
DT185 Issued in MN
Practice address
810 Independence Dr
Mankato, MN 56001-7767
Phone
(507) 387-3249
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Therapist 125J00000X DT185 MN Primary

Addresses

Primary practice location

810 Independence Dr
Mankato, MN 56001-7767

Mailing address

329 Tanager Path
Mankato, MN 56001-6396
Phone (507) 995-0323

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
DT185MNMDDental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda L. Hyland D.D.S. P.a CurrentSince Jul 28, 2025 Accepting new patients

Locations

810 Independence Dr
Mankato, MN 56001
Phone (507) 387-3249

Organizations & group practices 1

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": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1861374449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 TANAGER PATH",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016396",
            "telephone_number": "507-995-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 INDEPENDENCE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017767",
            "telephone_number": "507-387-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBEN",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.