Active NPI
Lee Ann Herbert
- General Practice Dentistry
- Plymouth, MN
National Provider Identifier
1962525089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D10013
- Practice address
- 1525 Co Rd 101 N
Plymouth, MN 55447 - Phone
- (763) 475-2820
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D10013 | MN | Primary |
Addresses
Primary practice location
1525 Co Rd 101 N
Plymouth, MN 55447
Mailing address
3635 Alvarado LN N
Plymouth, MN 55446-2879
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160225000706 | MN | Order and Referring Only - Dentist | 3173828316 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnesen & Herbert DDS | General Practice | 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.
-
- General Practice Dentistry
- Plymouth, MN
- NPI 1518033166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962525089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3635 ALVARADO LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554462879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 CO RD 101 N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "55447",
"telephone_number": "763-475-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERBERT",
"first_name": "LEE ANN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D10013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.