DR. ROGER ALAN MONDALE D.D S.
NPI 1023170248
Dentist - General Practice in Plymouth, MN

Q: What is Roger Mondale's NPI number?

The NPI number for Roger Mondale is 1023170248. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Q: What is Roger Mondale's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Roger Mondale was last updated on December 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 14, 2006PECOS Enrolled

10600 OLD COUNTY RD. 15, SUITE 120, PLYMOUTH, MN 55441(763) 512-8500(763) 512-8592 Get Directions Write a Review

NPPES record last updated: December 16, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Roger Alan Mondale D.d S. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROGER ALAN MONDALE D.D S. (NPI 1023170248) is an individual general practice provider in Plymouth, Minnesota, licensed in Minnesota (D7579) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023170248

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. ROGER ALAN MONDALECredential: D.D S.

Location Address10600 OLD COUNTY RD. 15, SUITE 120Plymouth, MN 55441

Mailing Address10600 Old County Rd 15, Suite 120Plymouth, MN 55441 · (763) 512-8500 · Fax (763) 512-8592

Phone(763) 512-8500

Fax(763) 512-8592

Sole ProprietorYes

Enumeration DateDecember 14, 2006

Last NPPES UpdateDecember 16, 2009

✔ NPI 1023170248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MN · D7579

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

10600 OLD COUNTY RD. 15, Plymouth, MN 55441

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Other Identifiers 1

Medicaid970215600MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Roger Alan Mondale D.d S. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55441 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roger Mondale's NPI number?

The NPI number for Roger Mondale is 1023170248. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Where is Roger Mondale located?

Roger Mondale practices at 10600 Old County Rd. 15 Suite 120, Plymouth, MN 55441. The listed phone number is (763) 512-8500.

What is Roger Mondale's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Roger Mondale enrolled in Medicare?

Yes. Roger Mondale is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Roger Mondale was last updated on December 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.