ROCHESTER PEDIATRIC DENTISTRY LLC (NPI# 1609272822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609272822 |
| Entity Type | Organization |
| Organization Name | ROCHESTER PEDIATRIC DENTISTRY LLC |
| Practice Address |
1705 S Boradway Ave Ste B Rochester MN 55904-7960 |
| Practice Telephone | 5072880102 |
| Practice Fax Number | 5072521445 |
| Mailing Telephone | 5072880102 |
| Mailing Fax Number | 5072521445 |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2020-09-23 |
| Authorized Official Name | DR. KELLY A JONES (OWNER- DENTIST) |
| Authorized Official Telephone | 5072880102 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D13120 | MN | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
1705 S BORADWAY AVE STE B |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55904-7960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558912303 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1200 Eastgate Drive S.e., Rochester, MN 55904 | 2019-09-24 |
| 1952954992 | Jane Yaakni Hopaki | Midwife | 1224 Eastgate Dr Se, Rochester, MN 55904 | 2019-07-18 |
| 1851896187 | Hamdi A Ali | Pediatrics | 26 Mayo Park Dr Se, Rochester, MN 55904 | 2018-03-28 |
| 1255847059 | Brooke Maleszewski | Nurse Practitioner | 821 3rd Ave Se Ste 15, Rochester, MN 55904 | 2017-12-17 |
| 1699215988 | Maximus Language Resources | Interpreter | 1775 3rd Ave Se, Rochester, MN 55904 | 2017-03-06 |
| 1215484803 | Kylene Starr Allen | Social Worker | 343 Woodlake Dr. Se, Zumbro Valley Health Center, Rochester, MN 55904 | 2016-09-01 |
| 1013384627 | Breathe Easy Medical Supplies Inc. | Durable Medical Equipment & Medical Supplies | 40 16th St. Sw Suite G, Rochester, MN 55904 | 2015-08-31 |
| 1932473105 | Michelle Lee Sather | Counselor | 343 Woodlake Drive Se, Rochester, MN 55904 | 2012-03-05 |
| 1538453022 | Amy M Carey | Social Worker | 40 16th Street Sw, Suite D, Rochester, MN 55904 | 2011-06-02 |
| 1396059895 | Lisa Marie Bingham | Optometrist | 111 S. Broadway, Rochester, MN 55904 | 2010-07-27 |
| Find all providers in zip 55904 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306313150 | Jeffrey I Goldberg Dds Pllc | Clinic/Center | 1655 Elmwood Ave Ste 100, Rochester, NY 14620-3426 | 2018-10-30 |
| 1497294326 | Quarry Hill Family Dental, LLC | Clinic/Center | 828 11th Ave Ne, Rochester, MN 55906-4457 | 2017-02-12 |
| 1396199832 | Pdg, Pa | Clinic/Center | 3780 Marketplace Dr Nw Ste 112, Rochester, MN 55901-3225 | 2016-04-21 |
| 1598186645 | Southcoast Community Dental Care | Clinic/Center | 603 New Bedford Rd, Rochester, MA 02770-4125 | 2013-12-16 |
| 1093087389 | Sarah Jean Dennison | Clinic/Center | 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 | 2012-02-01 |
| 1669649166 | East Avenue Dentistry Pllc | Clinic/Center | 1641 East Ave, Rochester, NY 14610-1616 | 2008-05-13 |
| 1942475330 | Minnesota State Colleges and Universities - Rochester Community & Tech | Clinic/Center | 851 30th Ave Se, Rochester, MN 55904-4915 | 2008-04-25 |
| 1730284787 | Groves & Kelley Dds PC | Clinic/Center | 50 Cedarfield Commons, Suite D, Rochester, NY 74612 | 2006-09-14 |
| 1538767876 | Rochester Dental Professionals LLC | Clinic/Center | 723 2nd St Sw, Rochester, MN 55902-2921 | 2020-10-09 |
| 1609496504 | Regional Health Reach Inc. | Clinic/Center | 89 Genesee St Ste 1408, Rochester, NY 14611-3201 | 2020-04-21 |
| Find all providers in ROCHESTER | ||||
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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.