Plum Tree Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PLUM TREE DENTAL

Practice address

202 S 5TH Ave
Virginia, MN 55792-2638

Phone

(218) 749-1776

Fax

(218) 749-0866

NPI assigned

Jul 17, 2025

Organization subpart

No

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

Authorized official

Name

Clarissa Sparkman, DMDNPI 1689937526

Title

Owner/Dentist

Phone

(218) 749-1776

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Clarissa Mary Sparkman, D.M.D

  • Dentist
  • Hibbing, MN
  • NPI 1689937526
  NPD Authorized official
• Cameron Joseph Jayson, D.D.S., M.A., D.B.A.

  • Dentist
  • Virginia, MN
  • NPI 1184666448
  NPD (past)

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1093607764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S 5TH AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922638",
            "telephone_number": "218-749-1776",
            "fax_number": "218-749-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S 5TH AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922638",
            "telephone_number": "218-749-1776",
            "fax_number": "218-749-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLUM TREE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "SPARKMAN",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "218-749-1776",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elana Sue Pfeifer
• Makenzie Pierce
• Plesha Chiropractic, P.a.
• Brian James Plesha, DC
• Jacklyn Marie Plesha
• Kevin E Polla, PTA
• Laura Pollak, PHARM.D.
• Miranda Prentice
• Vincent Gianni Prince
• James Robert Prittinen, DDS

• General Practice Dentistry in Virginia, MN
• Providers in Virginia, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.