NPIMap

Organization Active NPI

Schroeder Family Dentistry, PC

  • General Practice Dentistry
  • Grand Rapids, MN
National Provider Identifier
1235314295
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8189 Issued in MN
Legal business name
SCHROEDER FAMILY DENTISTRY, PC
Practice address
403 NE 5TH Ave
Grand Rapids, MN 55744-2928
Phone
(218) 326-9051
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Dr. Stephen D Schroeder, DDSNPI 1295893428
Title
Owner
Phone
(218) 326-9051

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 8189 MN Primary

Addresses

Primary practice location

403 NE 5TH Ave
Grand Rapids, MN 55744-2928

Mailing address

403 NE 5TH Ave
Grand Rapids, MN 55744-2928
Phone (218) 326-9051

National Provider Directory

National Provider Directory
Tax ID family
Schroeder Family Dentistry PC2 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

403 NE 5th Ave
Grand Rapids, MN 55744
Phone (218) 326-9051

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 3

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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1235314295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 NE 5TH AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442928",
            "telephone_number": "218-326-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 NE 5TH AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442928",
            "telephone_number": "218-326-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHROEDER FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-326-9051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.