Periodontal Specialists, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

07829 Issued in MN

Legal business name

PERIODONTAL SPECIALISTS, PA

Practice address

2112 Viking Dr NW
Rochester, MN 55901-3522

Phone

(507) 288-1338

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Tanyia Bucher

Title

Practice Administrator

Phone

(507) 451-8151

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740359546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 VIKING DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013522",
            "telephone_number": "507-288-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 VIKING DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013522",
            "telephone_number": "507-288-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCHER",
        "authorized_official_first_name": "TANYIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "507-451-8151"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "07829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliana Perez Botero, MD
• Judit Maria Perez Ortiz, MD, PHD
• Domingo G Perez, M.D.
• Jasmine Nicole Perez, OT
• Jennifer Lee Perez, MD, PHD
• Maria Peris Celda, MD, PHD
• Perkins Enterprises, Inc.
• Erica J Perkins
• Kathryn C. Perkins, CRNA
• Mark Gregory Perkins, LADC

• Periodontics in Rochester, MN
• Providers in Rochester, MN by specialty
• Periodontics 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.