NPIMap

Organization Active NPI

Riverside Dental Care,LLC

  • General Practice Dentistry
  • Saint Peter, MN
National Provider Identifier
1861579658
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RIVERSIDE DENTAL CARE,LLC
Practice address
217 Nassau St
Saint Peter, MN 56082-2055
Phone
(507) 931-5646
Fax
(507) 934-0148
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michelle Denise Lund, D.D.S.NPI 1538246319
Title
Owner
Phone
(507) 931-5646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

217 Nassau St
Saint Peter, MN 56082-2055

Mailing address

217 Nassau St
Saint Peter, MN 56082-2055
Phone (507) 931-5646

Other identifiers 1

IdentifierTypeStateIssuer
J33063DAHOtherMNBCBS MEDICAL ID NUMBER

National Provider Directory

National Provider Directory

Locations

217 Nassau St
Saint Peter, MN 56082
Phone (507) 931-5646

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861579658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 NASSAU ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560822055",
            "telephone_number": "507-931-5646",
            "fax_number": "507-934-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 NASSAU ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560822055",
            "telephone_number": "507-931-5646",
            "fax_number": "507-934-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-931-5646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL ID NUMBER",
            "identifier": "J33063DAH",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peter, MN

Sources for this page

  • 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.