St. Cloud Family Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ST. CLOUD FAMILY DENTAL PLLC

Practice address

816 W Saint Germain St Ste 101
Saint Cloud, MN 56301-3511

Phone

(320) 252-2454

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Barbra Curtis

Title

Business Administrator

Phone

(651) 470-9590

Specialties & licenses 1

Addresses

Practitioners 4

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

• Jacoby Joanne Hernick, DDS

  • General Practice Dentistry
  • Saint Cloud, MN
  • NPI 1467941211
  NPD
• Alaina Michelle Hull, DDS

  • General Practice Dentistry
  • Saint Cloud, MN
  • NPI 1447500186
  NPD (past)
• Russell Thomas Peterson, DDS

  • Dentist
  • Saint Cloud, MN
  • NPI 1457513616
  NPD (past)
• Thomas Merlin Peterson, DDS

  • General Practice Dentistry
  • St Cloud, MN
  • NPI 1891806709
  NPD (past)

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1699525915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 305TH AVE NE",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550086704",
            "telephone_number": "651-470-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W SAINT GERMAIN ST STE 101",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013511",
            "telephone_number": "320-252-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "BARBRA",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "651-470-9590"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Cloud Area School District 742
• St. Cloud Carefree Living
• St. Cloud Comfort Rides Inc.
• St. Cloud Ear, Nose & Throat - Surgical Suites LLC
• St. Cloud Ear, Nose & Throat Clinic, P.a.
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital

• Dental Clinic/Center in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.