Active NPI
Ken Zhou, DDS
- Pediatric Dentistry
- Mankato, MN
National Provider Identifier
1861918567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 36132
- Practice address
- 309 Holly LN
Mankato, MN 56001-5422 - Phone
- (507) 388-2120
- NPI assigned
- Aug 15, 2017
- Last updated
- Nov 8, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D13908 | MN | |
| Pediatric Dentistry | 1223P0221X | 36132 | TX | Primary |
Addresses
Primary practice location
309 Holly LN
Mankato, MN 56001-5422
Mailing address
17772 72ND PL N
Maple Grove, MN 55311-2525
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 |
|---|---|---|---|
| D13908 | MN | MD | Dentist |
| 36132 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1861918567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17772 72ND PL N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553112525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 HOLLY LN",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015422",
"telephone_number": "507-388-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZHOU",
"first_name": "KEN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-15",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13908",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "36132",
"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 Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.