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NPI Code Detail

MEDICARE: CHILDREN'S DENTAL HEALTH SERVICES

MEDICARE: CHILDREN'S DENTAL HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/CenterH3646MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1780529200OTHERMNREG. DENTAL HYGIENIST

General Provider Information

NPI Number : 1881780864
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S DENTAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 1615 14TH ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0257
Country : US
Telephone Number : 507-529-0436
Fax Number : 507-529-0435
Provider Business Practice Location Address
First Line : 1615 14TH ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0257
Country : US
Telephone Number : 507-529-0436
Fax Number : 507-529-0435
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. SARAH ANNE HAYES ANDERSON
Credential :
Telephone Number : 507-529-0436
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/16/2025

Similar Medicare Providers

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1699883751 — KATIE K. POST DDS
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1730476987 — DR. TIMOTHY S HANSEN DDS
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1952669517 — DR. MATTHEW T PENZ D.D.S.
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Directions to “CHILDREN'S DENTAL HEALTH SERVICES ” Practice Location

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