Individual provider Active NPI

Kimberly Ann Rauk, D.D.S.

  • General Practice Dentistry
  • Alexandria, MN
National Provider Identifier
1427102722
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11817 Issued in MN
Practice address
510 22ND Ave E
Suite 601
Alexandria, MN 56308-4653
Phone
(320) 763-5556
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11817 MN Primary

Addresses

Primary practice location

510 22ND Ave E
Suite 601
Alexandria, MN 56308-4653

Mailing address

510 22ND Ave E
Suite 601
Alexandria, MN 56308-4653
Phone (320) 763-5556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D11817MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427102722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E",
            "address_2": "SUITE 601",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084653",
            "telephone_number": "320-763-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E",
            "address_2": "SUITE 601",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084653",
            "telephone_number": "320-763-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • 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.