NPIMap

Organization Active NPI

St Peter Family Dental Center, P.a.

  • General Practice Dentistry
  • Saint Peter, MN
National Provider Identifier
1215042445
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ST PETER FAMILY DENTAL CENTER, P.A.
Practice address
402 Sunrise Dr
Saint Peter, MN 56082-1342
Phone
(507) 931-1230
Fax
(507) 931-1493
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
Dr. Mark E ConoverNPI 1437264694
Title
Owner
Phone
(507) 931-1230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

402 Sunrise Dr
Saint Peter, MN 56082-1342

Mailing address

402 Sunrise Dr
Saint Peter, MN 56082-1342
Phone (507) 931-1230

National Provider Directory

National Provider Directory

Locations

402 Sunrise Dr
Saint Peter, MN 56082
Phone (507) 931-1230

Practitioners & affiliated clinicians

Practitioners 4

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1215042445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821342",
            "telephone_number": "507-931-1230",
            "fax_number": "507-931-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821342",
            "telephone_number": "507-931-1230",
            "fax_number": "507-931-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETER FAMILY DENTAL CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "CONOVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-931-1230",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.