Individual provider Active NPI

Heather Joan Heathcote Luebben, ADT, RDH

  • Advanced Practice Dental Therapist
  • Bloomington, MN
National Provider Identifier
1871747865
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice Dental TherapistTaxonomy code 125K00000X
License
DT4 Issued in MN
Practice address
8600 Nicollet Ave S
Bloomington, MN 55420-2824
Phone
(529) 541-2888
Fax
(952) 541-2889
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H6785 MN
Advanced Practice Dental Therapist 125K00000X DT4 MN Primary

Addresses

Primary practice location

8600 Nicollet Ave S
Bloomington, MN 55420-2824

Mailing address

8960 Springbrook Drive NW
Suite 150
Minneapolis, MN 55433-5852
Phone (763) 784-7570

Other practice location 1

8960 Springbrook Dr NW
Suite 150
Minneapolis, MN 55433-5852
Phone (763) 784-7570

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
H6785MNMDDental Hygienist
DT4MNMDAdvanced Practice Dental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1871747865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8960 SPRINGBROOK DRIVE NW",
            "address_2": "SUITE 150",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554335852",
            "telephone_number": "763-784-7570",
            "fax_number": "763-785-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NICOLLET AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202824",
            "telephone_number": "529-541-2888",
            "fax_number": "952-541-2889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8960 Springbrook Dr NW",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554335852",
            "country_code": "US",
            "telephone_number": "763-784-7570",
            "fax_number": "763-785-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEBBEN",
        "first_name": "HEATHER",
        "middle_name": "JOAN HEATHCOTE",
        "credential": "ADT, RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H6785",
            "primary": false
        },
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "MN",
            "license": "DT4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

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