FERGUS FALLS DENTAL GROUP NPI 1205991866

NPI Information

  • NPI: 1205991866
  • Provider Name: FERGUS FALLS DENTAL GROUP
  • Classification: Dentist - 1223D0001X
  • Specialization: Dental Public Health
  • Entity Type: Organization
  • Address: 1121 PEBBLE LAKE RD
    FERGUS FALLS, MN
    ZIP 56537
  • Phone: (218) 739-7254

Map and Directions

Get Directions

NPI Details

FERGUS FALLS DENTAL GROUP is a dental public health dentist in Fergus Falls, MN. The provider is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. FERGUS FALLS DENTAL GROUP NPI is 1205991866. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1121 PEBBLE LAKE RD
FERGUS FALLS, MN
ZIP 56537
Phone: (218) 739-7254

The provider's authorized official is Rod L. Kornrumpf .
The authorized official title is Adult Mental Health Administrator and has the following contact phone number (651) 431-5003.

The enumeration date for this NPI number is 12/26/2006 and was last updated on 2/27/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223D0001XDentistDental Public HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1102325000MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI