Pediatric and Adolescent Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC AND ADOLESCENT DENTISTRY

Practice address

212 Star St
Mankato, MN 56001-4825

Phone

(507) 387-4784

Fax

(507) 387-4078

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Lowell Walton, DDSNPI 1841284411

Title

Owner

Phone

(507) 387-4784

Specialties & licenses 1

Addresses

Locations

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

• James Lowell Walton, DDS

  • Pediatric Dentistry
  • Mankato, MN
  • NPI 1841284411
  NPD (past) Authorized official
• Dorthe Hartmann, DDS

  • Pediatric Dentistry
  • Mankato, MN
  • NPI 1346239605
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699747378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 STAR ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014825",
            "telephone_number": "507-387-4784",
            "fax_number": "507-387-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 STAR ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014825",
            "telephone_number": "507-387-4784",
            "fax_number": "507-387-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LOWELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-387-4784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan E Pearson, MD
• Anitha Peddireddy, MDS
• Jonathan Pedersen, PHYSICIAN ASSISTANT
• Glen Pederson-Linn
• Philip Andrew Pederson, PHARMD
• Pediatric Therapy Services Inc
• Richard J Peller, MD
• Susan W Peller, APRN, CNP
• Taylor Lynn Pelzel
• Payton Lee Pendergast, DT

• All providers in Mankato, MN
• Pediatric Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.