Jodi Michelle Fonkert, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10807 Issued in MN

Practice address

1101 South First Street
Suite 3
Willmar, MN 56201

Phone

(320) 235-2780

Fax

(320) 235-8838

NPI assigned

Oct 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hanson and Fonkert Dental Clinic PA

  • Dentist
  • Willmar, MN
  • NPI 1750465753
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285718304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SOUTH FIRST STREET",
            "address_2": "SUITE 3",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-235-2780",
            "fax_number": "320-235-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SOUTH FIRST STREET",
            "address_2": "SUITE 3",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-235-2780",
            "fax_number": "320-235-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONKERT",
        "first_name": "JODI",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30751330",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flannigan Chiropractic PA (Renew Chiropractic)
• Emily Ann Flannigan, D.C.
• Crystal Lynn Fleischhacker, CNP
• Kenneth M Flowe, MD
• Keran A Flynn-Kroska, LMFT
• Janice Kae Forkrud, RD, LD, CDE
• Jessica Fredrickson, LPCC
• Fresenius Medical Care Centracare Dialysis, LLC (Fresenius Kidney Care Willmar)
• Kaia Marie Friedlund, PA-C
• Nicole M Fries, PHARMD

• Dentist in Willmar, MN
• Providers in Willmar, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.