Individual provider Active NPI

Heidi Lohn Smith, DDS

  • Dentist
  • Burnsville, MN
National Provider Identifier
1962480343
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11806 Issued in MN
Practice address
550 W. Burnsville Pkwy
Suite 200
Burnsville, MN 55337
Phone
(952) 890-2791
Fax
(952) 277-0200
NPI assigned
Jan 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11806 MN Primary

Addresses

Primary practice location

550 W. Burnsville Pkwy
Suite 200
Burnsville, MN 55337

Mailing address

550 W. Burnsville Pkwy
Suite 200
Burnsville, MN 55337
Phone (952) 890-2791

Other identifiers 2

IdentifierTypeStateIssuer
223628100MedicaidMN
28012SCOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425000882 MN Order and Referring Only - DentistPractitioner - Dentist 2769586445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11806MNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of the City Dental Dentist Past Accepting new patients

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1962480343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W. BURNSVILLE PKWY",
            "address_2": "SUITE 200",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-890-2791",
            "fax_number": "952-277-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W. BURNSVILLE PKWY",
            "address_2": "SUITE 200",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-890-2791",
            "fax_number": "952-277-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HEIDI",
        "middle_name": "LOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223628100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28012SC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.