Individual provider · NPI-1
Jodi Lynn Amdahl, ADT/RDH
Advanced Practice Dental Therapist · Redwood Falls, MN
NPI number1407000490
StatusActive
Last updated in NPPESDec 12, 2025
Details
- NPI
- 1407000490
- Entity type
- Individual (NPI-1)
- Name
- Jodi Lynn Amdahl
- Credential
- ADT/RDH
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2008
- Certification date
- Dec 12, 2025
- Last updated
- Dec 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 125K00000X | Advanced Practice Dental Therapist | DT5 | MN | Yes |
| 124Q00000X | Dental Hygienist | H7202 | MN |
Other names
- Jodi Lynn Hager (Former Name)
Practice location
590 W Park RoadRedwood Falls, MN 56283
Phone 507-637-3581 · Fax 507-627-8894
Mailing address
210 4th Street, Po Box 272Balaton, MN 56115
Phone 507-276-1115
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