Courtney Bollingberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14878 Issued in MN

Practice address

607 18TH Ave NW
Austin, MN 55912-1848

Phone

(507) 433-9146

NPI assigned

May 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Schieck Dental, PA

  • General Practice Dentistry
  • Austin, MN
  • NPI 1982191979

  General Practice

  NPD (past)

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1104517002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N HOLLERUD ST",
            "city": "LYLE",
            "state": "MN",
            "postal_code": "559539719",
            "telephone_number": "507-440-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 18TH AVE NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559121848",
            "telephone_number": "507-433-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGBERG",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Anthony Bobby, M.S.W. L.I.C.S.W
• Fred Herman Bogott, M.D.
• Jessica L Bohren, C.N.M.
• James Andrew Bohrer, M.D.
• Bollingberg Chiropractic Clinic LLP
• Daniel Bollingberg, DC
• Faye E Bollingberg, D.C.
• Robert P. Bonacci, M.D.
• Danae Boorsma, CNP, FNP-BC
• Dawn Marie Bos, PHD, ARNP, FNP,PMHNP

• All providers in Austin, MN
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.