Sunrise River Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10152 Issued in MN

Legal business name

SUNRISE RIVER DENTAL PA

Practice address

26357 Forest Blvd
Wyoming, MN 55092-8353

Phone

(651) 462-7017

NPI assigned

Dec 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Therese Rydlund

Title

Cda, Rda

Phone

(651) 462-7017

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942361324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26357 FOREST BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26357 FOREST BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928353",
            "telephone_number": "651-462-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE RIVER DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYDLUND",
        "authorized_official_first_name": "THERESE",
        "authorized_official_title_or_position": "CDA, RDA",
        "authorized_official_telephone_number": "651-462-7017"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Donald Solberg
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• Benjamin Stanghelle, MD
• Deborah K Strand, MD
• Connie Lee Sugg, PT
• Kent W Svee, MD
• Stuart E Sybesma, MD
• Jessica A Szmanda, LPCC, LADC
• Todd Michael Thieman
• Sally Thurnbeck

• General Practice Dentistry in Wyoming, MN
• Providers in Wyoming, 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 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.