Healthcare Provider Details

I. General information

NPI: 1396621421
Provider Name (Legal Business Name): SARAH HOFFMANN ADT, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 BROADWAY ST NE
MINNEAPOLIS MN
55413-2164
US

IV. Provider business mailing address

2966 JONQUIL TRL N
LAKE ELMO MN
55042-8478
US

V. Phone/Fax

Practice location:
  • Phone: 612-746-1530
  • Fax:
Mailing address:
  • Phone: 507-848-8936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH11736
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code125J00000X
TaxonomyDental Therapist
License NumberDT187
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: