Personal Care Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PERSONAL CARE DENTISTRY

Practice address

2233 Hamline Ave N Ste 320
Roseville, MN 55113-5005

Phone

(651) 636-0655

NPI assigned

Oct 29, 2019

Organization subpart

No

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

Authorized official

Name

Brandy G. Fulton

Title

MGR

Phone

(651) 636-0655

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teodora Nikolaeva Baylon, D.D.S.

  • Dentist
  • Roseville, MN
  • NPI 1053639963
  NPD (past)
• Kyle Hunt, D.D.S.

  • General Practice Dentistry
  • Roseville, MN
  • NPI 1386050599
  NPD (past)
• Sara Mogensen Schadeberg, DDS

  • Dentist
  • Minneapolis, MN
  • NPI 1922596733
  NPD (past)

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1639713126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N STE 320",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135005",
            "telephone_number": "651-636-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N STE 320",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135005",
            "telephone_number": "651-636-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL CARE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "651-636-0655"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MICHEAL FUREY",
            "identifier": "1154427276",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. KYLE NPI",
            "identifier": "1386050599",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. DANIEL SHANNON NPI",
            "identifier": "1851490585",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. ANDREW HEINISCH NPI",
            "identifier": "1568876514",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drhunt@comcast.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2233 Hamline Ave N Ste 320",
            "city": "Roseville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551135005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Louise Peper, RN
• Perez Neuropsychology
• Perfect Touch Massage & Chiropractic, LTD
• Kahlil Permenter, DC
• Person to Person Home Care Limited Liability Company
• Andrea Leigh Petersen
• Michael James Petersen, D.D.S.
• Alyssa Marie Peterson, L.AC.
• Annika Peterson, APRN, CNP
• Gloria J Peterson, MD

• General Practice Dentistry in Roseville, MN
• Providers in Roseville, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.