NPIMap

Organization Active NPI

Family Dentist Tree, PA

Doing business as Family Dentist Tree

  • General Practice Dentistry
  • Rochester, MN
National Provider Identifier
1972636777
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTIST TREE, PA
Doing business as
Family Dentist Tree
Practice address
1011 Bel Air LN NW
Rochester, MN 55901-6992
Phone
(507) 288-1188
Fax
(507) 529-4065
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Marie Samuelson
Title
Business Manager
Phone
(507) 288-1188

Specialties & licenses 1

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

Addresses

Primary practice location

1011 Bel Air LN NW
Rochester, MN 55901-6992

Mailing address

1011 Bel Air LN NW
Rochester, MN 55901-6992
Phone (507) 288-1188

Other names 1

  • Family Dentist Tree Doing business as

National Provider Directory

National Provider Directory

Locations

1011 Bel Air Ln NW
Rochester, MN 55901
Phone (507) 288-1188

Practitioners & affiliated clinicians

Practitioners 9

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1972636777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BEL AIR LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016992",
            "telephone_number": "507-288-1188",
            "fax_number": "507-529-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BEL AIR LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016992",
            "telephone_number": "507-288-1188",
            "fax_number": "507-529-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTIST TREE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "507-288-1188"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentist Tree",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 29, 2007; 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.