NPIMap

Organization Active NPI

Walnut Street Dental, PLLC

  • General Practice Dentistry
  • Winona, MN
National Provider Identifier
1679398143
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WALNUT STREET DENTAL, PLLC
Practice address
120 Walnut St
Winona, MN 55987-3429
Phone
(507) 454-5854
Fax
(507) 454-7533
NPI assigned
Nov 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Dr. Carly Ann Sherod, DDS
Title
Dentist/Owner
Phone
(507) 454-5854

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

120 Walnut St
Winona, MN 55987-3429

Mailing address

120 Walnut St
Winona, MN 55987-3429
Phone (507) 454-5854

National Provider Directory

National Provider Directory
Tax ID family
Walnut Street Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1679398143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WALNUT ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873429",
            "telephone_number": "507-454-5854",
            "fax_number": "507-454-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WALNUT ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873429",
            "telephone_number": "507-454-5854",
            "fax_number": "507-454-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT STREET DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "SHEROD",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "507-454-5854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.