FAIRMONT FAMILY DENTISTRY, PA (NPI# 1356515969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356515969 |
| Entity Type | Organization |
| Organization Name | FAIRMONT FAMILY DENTISTRY, PA |
| Practice Address |
202 N Park St Fairmont MN 56031-2824 |
| Practice Telephone | 5072382818 |
| Practice Fax Number | 5072358914 |
| Mailing Telephone | 5072382818 |
| Mailing Fax Number | 5072358914 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |
| Authorized Official Name | JON THOMAS ERISKSON (PRESIDENT) |
| Authorized Official Telephone | 5072382812 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D10871 | MN | Ambulatory Health Care Facilities |
| Street Address |
202 N PARK ST |
| City | FAIRMONT |
| State | MN |
| Zip Code | 56031-2824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033127378 | Jon T Erickson | Dentist | 202 N Park St, Fairmont, MN 56031-2824 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407097025 | David Robert Rynders | Counselor | 301 Downtown Plaza, #3, Fairmont, MN 56031 | 2009-03-11 |
| 1992902449 | Wal-mart Stores, Inc. | Technician/Technologist | 1250 Goemann Road, Fairmont, MN 56031 | 2007-06-28 |
| 1417099813 | Thomas Joe Larson | Dentist | 800 Clinic Circle, Fairmont, MN 56031 | 2007-02-13 |
| 1912076795 | Rem Heartland Inc | Intermediate Care Facility, Mentally Retarded | 111 Dorothy Street, Fairmont, MN 56031 | 2006-11-07 |
| 1750466322 | Rem Heartland Inc | Intermediate Care Facility, Mentally Retarded | 107 Dorothy Street, Fairmont, MN 56031 | 2006-10-25 |
| 1588744155 | Kerri Lynn Henderson | Chiropractor | 115 1/2 West Blue Earth Ave, Fairmont, MN 56031 | 2006-10-17 |
| 1427142199 | Maurice Lee Shoen | Counselor | 115 West First St, Fairmont, MN 56031 | 2006-10-03 |
| 1538253703 | Nathan Craig Jorgenson | Dentist | 717 South State Street, Suite 600, Fairmont, MN 56031 | 2006-10-03 |
| 1942311154 | Leon James Rochovitz | Optometrist | 288 S State Street, Five Lakes Centre, Fairmont, MN 56031 | 2006-08-31 |
| 1215903414 | Mayo Clinic Hospital-rochester | Clinic/Center | 835 Johnson Street, Fairmont, MN 56031 | 2006-02-27 |
| Find all providers in zip 56031 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194106823 | Christopher L. Olsen, Dds Pllc | Clinic/Center | 717 S State St, Suite #2, Fairmont, MN 56031-4469 | 2015-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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| 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.