NPIMap

Organization Active NPI

Community Dental Care

  • General Practice Dentistry
  • Rochester, MN
National Provider Identifier
1891100772
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13437 Issued in MN
Legal business name
COMMUNITY DENTAL CARE
Practice address
1926 Collegeview Rd E
HC #116
Rochester, MN 55904-8201
Phone
(507) 258-4046
NPI assigned
Jun 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Dr. Jessica Jill Grabouski, D. D. S.
Title
Dentist
Phone
(712) 253-5703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D13437 MN Primary

Addresses

Primary practice location

1926 Collegeview Rd E
HC #116
Rochester, MN 55904-8201

Mailing address

3191 Lakeridge Dr NW
Rochester, MN 55901-6565

National Provider Directory

National Provider Directory

Locations

1926 College View Rd E
#116
Rochester, MN 55904
Phone (507) 258-4046

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1891100772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 LAKERIDGE DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 COLLEGEVIEW RD E",
            "address_2": "HC #116",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559048201",
            "telephone_number": "507-258-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "GRABOUSKI",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "712-253-5703",
        "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": "MN",
            "license": "D13437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.