The Salvation Army

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

867910000 Issued in MN

Legal business name

THE SALVATION ARMY

Doing business as

The Salvation Army Good Samaritan Dental Clinic

Practice address

120 N Broadway Ste B
Rochester, MN 55906-3728

Phone

(507) 529-4100

Fax

(507) 529-4101

NPI assigned

Nov 29, 2006

Last updated

Dec 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Allison Uthke-Scaletta, DELEGATED OFFICIAL

Title

Government Grantwriter

Phone

(651) 746-3543

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Salvation Army Good Samaritan Dental Clinic Doing business as

Tax ID family

The Salvation Army3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• The Salvation Army

  dba Caring Partners Adult Day Program

  • Adult Day Care Clinic/Center
  • Rochester, MN
  • NPI 1679887244
  NPD tax ID
• The Salvation Army

  dba Lakewood Adult Day Center

  • Adult Day Care Clinic/Center
  • Maplewood, MN
  • NPI 1992342513
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Salvation Army

  dba Lakewood Adult Day Center

  • Adult Day Care Clinic/Center
  • Maplewood, MN
  • NPI 1992342513
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Birmingham, RDH

  • Dental Hygienist
  • Rochester, MN
  • NPI 1265711451
  NPD (past)
• Connie Krueger, RDH

  • Dental Hygienist
  • Rochester, MN
  • NPI 1235451816
  NPD (past)
• Shelley Lynn Sperling, BS,RDH

  • Dental Hygienist
  • Rochester, MN
  • NPI 1922346907
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1093882656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 1ST AVE NE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559063706",
            "telephone_number": "507-529-4100",
            "fax_number": "507-529-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N BROADWAY STE B",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559063728",
            "telephone_number": "507-529-4100",
            "fax_number": "507-529-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SALVATION ARMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "UTHKE-SCALETTA",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "GOVERNMENT GRANTWRITER",
        "authorized_official_telephone_number": "651-746-3543",
        "authorized_official_credential": "DELEGATED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "867910000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER IDENTIFICATION #",
            "identifier": "867910000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Salvation Army Good Samaritan Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Salvation Army Good Samaritan Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Carabelli Group, LLC (Rochester Dental Health Affiliates)
• The Gables LLC
• The Gables, Inc.
• The Jay Clinic
• The Marmon Foundation
• The Salvation Army (Caring Partners Adult Day Program)
• The Therapy Space
• Emily Ann Theede, PT
• Amber Lauren Theel
• Amy Rebecca Theiler, P.A.-C.

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, 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 Dec 2, 2019; 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.