Southern Minnesota Sleep Center, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHERN MINNESOTA SLEEP CENTER, PLLC

Doing business as

Southern Minnesota Sleep Center, PLLC

Practice address

110 1St St N
Montgomery, MN 56069-1514

Phone

(920) 316-0002

NPI assigned

Aug 24, 2023

Last updated

Oct 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karisa Bollinger

Title

Marketing Manager

Phone

(507) 317-8039

Specialties & licenses 1

Addresses

Other names 1

• Southern Minnesota Sleep Center, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1750165171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 1ST ST N",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560691514",
            "telephone_number": "920-316-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 1ST ST N",
            "city": "MONTGOMERY",
            "state": "MN",
            "postal_code": "560691514",
            "telephone_number": "920-316-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MINNESOTA SLEEP CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "BOLLINGER",
        "authorized_official_first_name": "KARISA",
        "authorized_official_title_or_position": "MARKETING MANAGER",
        "authorized_official_telephone_number": "507-317-8039"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Minnesota Sleep Center, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Montgomery, MN
• Providers in Montgomery, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.