Healthcare Provider Details

I. General information

NPI: 1316610082
Provider Name (Legal Business Name): AMELIA JIN YUAN VOLKERT DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14455 S ROBERT TRL
ROSEMOUNT MN
55068-4932
US

IV. Provider business mailing address

14455 S ROBERT TRL
ROSEMOUNT MN
55068-4932
US

V. Phone/Fax

Practice location:
  • Phone: 651-450-7273
  • Fax:
Mailing address:
  • Phone: 651-335-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD14642
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD14642
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: