NPIMap

Organization Active NPI

Nomeland Dental LLC

  • Dentist
  • Faribault, MN
National Provider Identifier
1184847568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11041 Issued in MN
Legal business name
NOMELAND DENTAL LLC
Practice address
412 Heritage PL
Faribault, MN 55021-5248
Phone
(507) 334-7595
NPI assigned
Apr 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Thamas Jason Nomeland, D.D.S.
Title
President
Phone
(507) 334-7595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D11041 MN Primary

Addresses

Primary practice location

412 Heritage PL
Faribault, MN 55021-5248

Mailing address

412 Heritage PL
Faribault, MN 55021-5248

Other identifiers 1

IdentifierTypeStateIssuer
1415467OtherMNUNITED CONCORDIA

National Provider Directory

National Provider Directory
Tax ID family
Lake Marion Dental Care2 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.

Locations

412 Heritage Pl
Faribault, MN 55021
Phone (507) 334-7595

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184847568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215248",
            "telephone_number": "507-334-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOMELAND DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOMELAND",
        "authorized_official_first_name": "THAMAS",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-334-7595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1415467",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, 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.