Southern Minnesota Community Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHERN MINNESOTA COMMUNITY DENTAL CLINIC

Practice address

1501 North State Street
Waseca, MN 56093

Phone

(507) 835-3040

NPI assigned

Jan 13, 2021

Last updated

Jan 13, 2021By 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

Todd Fischer, DDS

Title

Owner/Dentist

Phone

(507) 835-3040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1285223339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NORTH STATE STREET",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "56093",
            "telephone_number": "507-835-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NORTH STATE STREET",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "56093",
            "telephone_number": "507-835-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MINNESOTA COMMUNITY DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "507-835-3040",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordana Schreiner
• Barbara Jo Scott
• Susan T. Seykora, R.D., L.D.
• Stephanie Smook, OTR/L
• John Allen Snow
• Ashley Ann Spain, OT
• Kelsi Sparks
• Matthew John Spreiter
• Clare Elizabeth Steffen, PHARM.D.
• Tiffany Stenzel, RN

• General Practice Dentistry in Waseca, MN
• Providers in Waseca, 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 Jan 13, 2021; 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.