Todd Matthew Palmer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11327 Issued in MN

Practice address

330 Heritage PL
Faribault, MN 55021-5251

Phone

(507) 332-8461

Fax

(507) 332-8397

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Southern Cities Clinic

  • General Practice Physician
  • Faribault, MN
  • NPI 1437218740
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881723716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215251",
            "telephone_number": "507-332-8461",
            "fax_number": "507-332-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HERITAGE PL",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215251",
            "telephone_number": "507-332-8461",
            "fax_number": "507-332-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "TODD",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristian Overland
• Kristine Marie Owen-Katona, LADC
• Asha Oyow
• Hibo Oyow
• Sandra Paddock, CNP
• Brianna Papow, COTA/L
• Melinda Sue Parker, PA-C
• Pathways to Healing Mental Health Services L.L.C
• Nancy K Paulson, LMFT
• Ayn Tanya Pavek, RD, LD

• General Practice Dentistry in Faribault, MN
• Providers in Faribault, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.