Kelly I Schroeder DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KELLY I SCHROEDER DDS

Practice address

1108 Western Ave
Fergus Falls, MN 56537-4808

Phone

(218) 736-4000

Fax

(218) 736-0766

NPI assigned

Sep 3, 2020

Last updated

Nov 27, 2023By 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

Charlene Klovstad

Title

Business Manager

Phone

(218) 736-4000

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Irene Schroeder, DDS

  • Dentist
  • Fergus Falls, MN
  • NPI 1902925480
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1770197030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 WESTERN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374808",
            "telephone_number": "218-736-4000",
            "fax_number": "218-736-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 WESTERN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374808",
            "telephone_number": "218-736-4000",
            "fax_number": "218-736-0766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 E Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Fergus Falls",
            "state": "MN",
            "postal_code": "565372217",
            "country_code": "US",
            "telephone_number": "218-736-5627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY I SCHROEDER DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "KLOVSTAD",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "218-736-4000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "northernlakesdental@prtel.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1108 Western Ave",
            "city": "Fergus Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565374808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Laurie Karels, LPN
• Jedidiah Donald Kasey, PTA
• Nicole Marie Kashmark
• Kunal Kaushik, M.D.
• Cindy J Keller, MSW
• Tanya Kelsen
• Darryl S Kemp Jr., MD
• Randall James Kempfer, O.D.
• Tara Amber Kempfer, O.D.
• Colleen L Kennedy, LICSW

• Dental Clinic/Center in Fergus Falls, MN
• Providers in Fergus Falls, 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 Nov 27, 2023; 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.