NPIMap

Organization Active NPI

Spring Valley Dental

  • General Practice Dentistry
  • Preston, MN
National Provider Identifier
1053476564
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SPRING VALLEY DENTAL
Practice address
317 Saint Paul St SW
Preston, MN 55965-1097
Phone
(507) 765-3634
Fax
(507) 765-3645
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Genie Kuble
Title
Contact Officer
Phone
(920) 450-0157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

317 Saint Paul St SW
Preston, MN 55965-1097

Mailing address

317 Saint Paul St SW
Preston, MN 55965-1097

Other names 1

  • Preston Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Preston Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053476564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 SAINT PAUL ST SW",
            "city": "PRESTON",
            "state": "MN",
            "postal_code": "559651097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 SAINT PAUL ST SW",
            "city": "PRESTON",
            "state": "MN",
            "postal_code": "559651097",
            "telephone_number": "507-765-3634",
            "fax_number": "507-765-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "CONTACT OFFICER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preston Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Preston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.