FERGUS FALLS DENTAL GROUP (NPI# 1205991866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205991866 |
| Entity Type | Organization |
| Organization Name | FERGUS FALLS DENTAL GROUP |
| Practice Address |
1121 Pebble Lake Rd Fergus Falls MN 56537 |
| Mailing Address |
Po Box 64979 Saint Paul MN 55164-0979 |
| Practice Telephone | 2187397254 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2009-02-27 |
| Authorized Official Name | MR. ROD L. KORNRUMPF (ADULT MENTAL HEALTH ADMINISTRATOR) |
| Authorized Official Telephone | 6514315003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 102325000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558342469 | Fergus Falls Dental Group | Dentist | 1121 Pebble Lake Road, Box 503, Fergus Falls, MN 56537 | 2005-11-08 |
| Street Address |
1121 PEBBLE LAKE RD |
| City | FERGUS FALLS |
| State | MN |
| Zip Code | 56537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386800456 | Amy Carol Piechowski | Dental Hygienist | 1121 Pebble Lake Rd, Fergus Falls, MN 56537 | 2008-07-29 |
| 1235255373 | Philip George Mayer | Dentist | 1121 Pebble Lake Rd, Fergus Falls, MN 56537-3807 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1336771591 | Paul George Wawin | Psychiatry & Neurology | 712 Cascade St. S. Lake Region Healthcare, Fergus Falls, MN 56537 | 2020-02-06 |
| 1134604127 | Christopher Michael Kjolhaug | Physical Therapist | 1131 South Mabelle Ave, Fergus Falls, MN 56537 | 2018-09-26 |
| 1619406808 | Aaron John Teigen | Physical Therapist | 1304 Lincoln Ave W, Suite C, Fergus Falls, MN 56537 | 2017-06-09 |
| 1003272154 | Anthony Gettel Dc LLC | Chiropractor | 755 Wildwood Trail, Fergus Falls, MN 56537 | 2016-01-05 |
| 1447628912 | Kelsey Shea | Student in an Organized Health Care Education/Training Program | 20743 Red Oak Dr., Fergus Falls, MN 56537 | 2015-09-14 |
| 1881070217 | Vineet Ganapati | Dentist | 2001 W Lincoln Ave # 33, Fergus Falls, MN 56537 | 2015-08-07 |
| 1497004832 | Beverly Renae Reiff | Registered Nurse | 22279 River Oaks Drive, Fergus Falls, MN 56537 | 2012-08-30 |
| 1114221421 | Jane Mary Bjornson | Social Worker | 21081 County Hwy 1, Fergus Falls, MN 56537 | 2010-12-29 |
| Find all providers in zip 56537 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558342469 | Fergus Falls Dental Group | Dentist | 1121 Pebble Lake Road, Box 503, Fergus Falls, MN 56537 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076073 | Rae Ann Ann Swanson | Dentist | 755 Florida Ave S, Minneapolis, MN 55426-1784 | 2020-09-02 |
| 1083178149 | Lift Dental Pllc | Dentist | 124 2nd St S Ste 101, Stillwater, MN 55082-5179 | 2019-01-23 |
| 1669842662 | Children's Dental Services | Dentist | 229 W Lake St, Chisholm, MN 55719 | 2015-10-02 |
| 1407224827 | Children's Dental Services | Dentist | 325 N Sibley Ave, Litchfield, MN 55355-2150 | 2015-09-02 |
| 1194095778 | Matthew Allen Olson | Dentist | 715 11th St N Ste 106b, Moorhead, MN 56560-2000 | 2012-01-12 |
| 1801118039 | Omar Dyab Dds Pa | Dentist | 13590 Northdale Blvd, Suite 300, Rogers, MN 55374-2150 | 2010-02-15 |
| 1407973605 | Childrens Dental Services Inc | Dentist | 636 Broadway St. Ne, Minneapolis, MN 55413 | 2007-03-23 |
| 1437287679 | Mississippi Headwaters Area Dental Health Center, Inc. | Dentist | 616 America Ave Nw Ste 340, Attention Mary Marchell, Bemidji, MN 56601-3871 | 2007-03-01 |
| 1437238052 | Tracey Roseann Charles | Dentist | 9345 Calypso Trail Nw, Bemidji, MN 56601 | 2006-11-03 |
| 1386722585 | William Lynn Canada | Dentist | 619 Kay Ave Se, Bemidji, MN 56601-3638 | 2006-11-02 |
| Find all providers with the same taxonomy | ||||
| City | FERGUS FALLS |
| Zip Code | 56537 |
Please comment or provide details below to improve the information on FERGUS FALLS DENTAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.