Individual provider Active NPI

Justin Robert Scholl, RDH, RDA

  • Dental Hygienist
  • Cambridge, MN
National Provider Identifier
1568351989
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H7756 Issued in MN
Practice address
140 Birch St N Ste 114
Cambridge, MN 55008-1507
Phone
(763) 347-4399
NPI assigned
Jul 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H7756 MN Primary

Addresses

Primary practice location

140 Birch St N Ste 114
Cambridge, MN 55008-1507

Mailing address

140 Birch St N Ste 114
Cambridge, MN 55008-1507
Phone (763) 347-4399

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
H7756MNMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Source Dental Clinic PastSince Jul 9, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1568351989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N STE 114",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081507",
            "telephone_number": "763-347-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N STE 114",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081507",
            "telephone_number": "763-347-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLL",
        "first_name": "JUSTIN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "RDH, RDA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H7756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.