Karissa Goetsch, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13671 Issued in MN

Practice address

109 Johnson Ave N
Fosston, MN 56542-1327

Phone

(320) 309-5882

NPI assigned

May 24, 2016

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prairie Pines Dental, PLLC

  • Dental Clinic/Center
  • Fosston, MN
  • NPI 1578291803
  NPD Authorized official
• Sjulson Family Dentistry

  • Dentist
  • Fosston, MN
  • NPI 1124386099
  NPD (past)

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1629426218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 JOHNSON AVE N",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421327",
            "telephone_number": "218-435-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 JOHNSON AVE N",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421327",
            "telephone_number": "320-309-5882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 County Highway 10",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554322124",
            "country_code": "US",
            "telephone_number": "763-717-3989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7600 France Ave S Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "55435",
            "country_code": "US",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOETSCH",
        "first_name": "KARISSA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fosston Chiropractic Clinic, P.a.
• Fosston Family Dental Inc.
• Fosston Long Term Care Pharmacy, Inc (Nord's Long Term Care Pharmacy)
• Fosston Pharmacy & Gifts Inc (Nords Pharmacy and Gifts)
• Jennifer Francis, ATC
• Camille J Hagen, RD,LD
• David E. Halvorson
• Headwaters Health PC
• Health Services Network, Inc (Cornerstone Residence)
• Leah Ann Hemmingsen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.