NPIMap

Organization Active NPI

Rochester Endodontics, PA

  • Endodontics
  • Rochester, MN
National Provider Identifier
1326398025
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D11595 Issued in MN
Legal business name
ROCHESTER ENDODONTICS, PA
Practice address
116 Elton Hills LN NW
Suite 100
Rochester, MN 55901-3602
Phone
(507) 288-8363
Fax
(507) 288-4456
NPI assigned
Sep 11, 2012
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Dr. Gerald J Gray, DDS, MSNPI 1518086016
Title
President
Phone
(507) 272-4912

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D8111 MN
Endodontics 1223E0200X D13634 MN
Endodontics 1223E0200X D11595 MN Primary

Addresses

Primary practice location

116 Elton Hills LN NW
Suite 100
Rochester, MN 55901-3602

Mailing address

116 Elton Hills LN NW
Suite 100
Rochester, MN 55901-3602
Phone (507) 288-8363

National Provider Directory

National Provider Directory

Locations

116 Elton Hills Ln NW
Ste 100
Rochester, MN 55901
Phone (507) 288-8363

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1326398025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 ELTON HILLS LN NW",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013602",
            "telephone_number": "507-288-8363",
            "fax_number": "507-288-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 ELTON HILLS LN NW",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013602",
            "telephone_number": "507-288-8363",
            "fax_number": "507-288-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER ENDODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-272-4912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D8111",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D13634",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.