Sandra Louise Hyvarinen Davenport, M.D.

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

29543 Issued in MN

Practice address

6109 W 105TH St
Bloomington, MN 55438-1833

Phone

(952) 831-5522

Fax

(952) 831-0381

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1912044918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6109 W 105TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381833",
            "telephone_number": "952-831-5522",
            "fax_number": "952-831-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 W 105TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381833",
            "telephone_number": "952-831-5522",
            "fax_number": "952-831-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "SANDRA",
        "middle_name": "LOUISE HYVARINEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MN",
            "license": "29543",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "29543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034451",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandre Darveaux
• Daryeel Therapy LLC
• Jennifer Ellen Dashow, BS, LADC
• Eva Dassin
• John Michael Daugherty, D.D.S.
• David L. Johnson, MD, LTD
• Suzanne Kay Davidowitz, MD
• Araiya G Davidson
• Jeremy Keith Davis, LPCC, LPC, LADC, SAC
• Michelle Davis, PA-C

• Clinical Genetics (M.D.) Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinical Genetics (M.D.) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.