Patricia Fernandes Boettner, DDS, MS

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

License

D13422 Issued in MN

Practice address

1835 County Road C W Ste 200
Roseville, MN 55113-1353

Phone

(651) 636-2016

NPI assigned

Nov 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Patricia Fernandes Boettner Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 15, 2018 through Nov 15, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1700153368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W STE 2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132551",
            "telephone_number": "651-746-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 COUNTY ROAD C W STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131353",
            "telephone_number": "651-636-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTNER",
        "first_name": "PATRICIA",
        "middle_name": "FERNANDES",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13422",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MN",
            "license": "D13422",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FL34",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": "D13422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "FERNANDES BOETTNER",
            "prefix": "DR.",
            "credential": "DDS, MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meagan Nicole Bliese, PA-C
• Nathan D Block, MD
• Malaurie Bluhm, LPCC
• Julia Boaz, APRN
• Bodymind Alchemy LLC
• Jeff O Bohlman, PA
• Nukunu Boley, RN
• Francis Bonaldo Begnoche, L.AC.
• Bilqisa Booker
• Linda M Borgen, RN

• Orofacial Pain Dentistry in Roseville, MN
• Providers in Roseville, MN by specialty
• Orofacial Pain Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.