Healthcare Provider Details

I. General information

NPI: 1356269997
Provider Name (Legal Business Name): ANDREW JAMES KLUMP DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 DELAWARE ST SE
MINNEAPOLIS MN
55455-0357
US

IV. Provider business mailing address

110 CARLSON PKWY APT 225
MINNETONKA MN
55305-5310
US

V. Phone/Fax

Practice location:
  • Phone: 612-625-6177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberR932
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: