Implant and Periodontal Professionals

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D12773 Issued in MN

Legal business name

IMPLANT AND PERIODONTAL PROFESSIONALS

Practice address

3142 Wellner Dr NE
Rochester, MN 55906-8388

Phone

(507) 206-6452

Fax

(507) 206-6186

NPI assigned

Jan 23, 2015

Last updated

Jan 8, 2016By 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

Dr. Emily Schmalz Kelly, DDS, MSNPI 1245467075

Title

Periodontitist

Phone

(651) 261-3644

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Emily Schmalz Kelly, D.D.S, M.S

  • Periodontics
  • Rochester, MN
  • NPI 1245467075
  Authorized official Same address or phone

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1306236708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 WELLNER DR NE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559068388",
            "telephone_number": "507-206-6452",
            "fax_number": "507-206-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 WELLNER DR NE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559068388",
            "telephone_number": "507-206-6452",
            "fax_number": "507-206-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPLANT AND PERIODONTAL PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "SCHMALZ",
        "authorized_official_title_or_position": "PERIODONTITIST",
        "authorized_official_telephone_number": "651-261-3644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "D12773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Friedrich Matthias Ilmer, MD
• Sumera Irie Ilyas, MD
• Nicole Rose Imhof, LICSW
• Reese Lee Imhof, MD
• John Michael Imp, PHD., L.P.
• In Home Health LLC (Heartland Home Health Care and Hospice)
• In Home Health LLC (Heartland Home Health Care and Hospice)
• In Home Health, LLC (ProMedica Hospice (Rochester))
• Megan Ince-Taeubel
• Independent School District No. 535

• Periodontics in Rochester, MN
• Providers in Rochester, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.