Kelly A Plote, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14677 Issued in MN

Practice address

4419 Air Base Rd
Hermantown, MN 55811-1847

Phone

(218) 728-2117

NPI assigned

May 27, 2010

Last updated

Jul 13, 2022By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Eversmiles Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Hermantown, MN
  • NPI 1285873687
  NPD (past)

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1447579594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121823",
            "telephone_number": "715-379-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 AIR BASE RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558111847",
            "telephone_number": "218-728-2117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13380 W Trepania Rd",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "WI",
            "postal_code": "54843",
            "country_code": "US",
            "telephone_number": "715-638-5144",
            "fax_number": "715-634-9919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15910 W Company Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "WI",
            "postal_code": "548435320",
            "country_code": "US",
            "telephone_number": "715-934-2224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15910 W Company Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "WI",
            "postal_code": "548435320",
            "country_code": "US",
            "telephone_number": "715-934-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLOTE",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028250",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14677",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7050-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Perkins
• Joslyn P Peterson
• Tommi Marie Peterson
• Jennifer Piasecki
• Pillars of Hermantown LLC (The Pillars of Hermantown)
• Heather Lynn Prekop
• Psych Solutions LLC
• Malia Elizabeth Putzel
• Audrey Robin Quach
• Quality Living Counseling, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.