Individual provider Active NPI

Molly Fernholz, RDH

  • Dental Hygienist
  • Faribault, MN
National Provider Identifier
1881588127
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H6062 Issued in MN
Practice address
400 4TH St NW
Faribault, MN 55021-5089
Phone
(507) 384-6830
Fax
(651) 431-7757
NPI assigned
Jun 3, 2025
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H6062 MN Primary

Addresses

Primary practice location

400 4TH St NW
Faribault, MN 55021-5089

Mailing address

400 4TH St NW
Faribault, MN 55021-5089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
H6062MNMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Cities Clinic CurrentSince Jun 8, 2025 Accepting new patients
Southern Cities Community Clinic PastSince Jun 8, 2025 Accepting new patients

Locations

400 4th St NW
Faribault, MN 55021
Phone (507) 384-6830

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1881588127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215089",
            "telephone_number": "507-384-6830",
            "fax_number": "651-431-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNHOLZ",
        "first_name": "MOLLY",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.