NPIMap

Organization Active NPI

Perry Dental, LTD

  • General Practice Dentistry
  • Wabasha, MN
National Provider Identifier
1891179958
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13557 Issued in MN
Legal business name
PERRY DENTAL, LTD
Practice address
1000 Hiawatha Dr E
Wabasha, MN 55981-1733
Phone
(651) 565-2888
Fax
(651) 565-2882
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Mrs. Sharon A Kennebeck
Title
Office Manager
Phone
(651) 565-2888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13557 MN Primary
General Practice Dentistry 1223G0001X 09963 MN

Addresses

Primary practice location

1000 Hiawatha Dr E
Wabasha, MN 55981-1733

Mailing address

1000 Hiawatha Dr E
Wabasha, MN 55981-1733
Phone (651) 565-2888

National Provider Directory

National Provider Directory
Tax ID family
Perry Dental LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1000 Hiawatha Dr E
Wabasha, MN 55981
Phone (651) 565-2888

Practitioners & affiliated clinicians

Practitioners 4

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": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1891179958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIAWATHA DR E",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811733",
            "telephone_number": "651-565-2888",
            "fax_number": "651-565-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIAWATHA DR E",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811733",
            "telephone_number": "651-565-2888",
            "fax_number": "651-565-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DENTAL, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "KENNEBECK",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-565-2888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "13557",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "09963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabasha, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.