Organization Active NPI

Zumbro Valley Endodontics

  • Endodontics
  • Rochester, MN
National Provider Identifier
1568067213
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ZUMBRO VALLEY ENDODONTICS
Practice address
2659 Superior Dr NW
Rochester, MN 55901-8533
Phone
(507) 281-1295
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Crystal Stephenson
Title
Office Manager
Phone
(507) 281-1295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary

Addresses

Primary practice location

2659 Superior Dr NW
Rochester, MN 55901-8533

Mailing address

2659 Superior Dr NW
Rochester, MN 55901-8533
Phone (507) 281-1295

Other identifiers 2

IdentifierTypeStateIssuer
1922101005MedicaidMN
1316321177MedicaidMN

National Provider Directory

National Provider Directory

Locations

2659 Superior Dr NW
Rochester, MN 55901
Phone (507) 281-1295

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": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1568067213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 SUPERIOR DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018533",
            "telephone_number": "507-281-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 SUPERIOR DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018533",
            "telephone_number": "507-281-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUMBRO VALLEY ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-281-1295"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922101005",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316321177",
            "state": "MN"
        }
    ],
    "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 Dec 1, 2020; 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.