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ROGER MONDALE, DDS
NPI 1053834481
Dentist - General Practice in Plymouth, MN

Active since July 18, 2017
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: July 30, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 30, 2024, Jul 19, 2024, Jul 21, 2022 and 1 more (4 updates tracked since 2017).

About Roger Mondale, Dds NPPES

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

ROGER MONDALE, DDS (NPI 1053834481) is a healthcare organization registered as a general practice in Plymouth, Minnesota and active in the NPI registry since July 2017. The organization lists Brian Patrick Mondale, Owner Sole Member, as its authorized official.

NPPES Registry Identity

NPI1053834481
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMONDALE DENTAL LLC
Location Address10600 OLD COUNTY RD 15, SUITE 120Plymouth, MN 55441-6205
Mailing Address10600 Old County Rd 15, Suite 120Plymouth, MN 55441-6205 · (763) 512-8500 · Fax (763) 512-8592
Phone(763) 512-8500
Fax(763) 512-8592
Organization SubpartNo
Authorized OfficialBrian Patrick MondaleOwner Sole Member · (763) 512-8500
Enumeration DateJuly 18, 2017
Last NPPES UpdateJuly 30, 20244 updates tracked since enumeration
✔ NPI 1053834481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
10600 OLD COUNTY RD 15, Plymouth, MN 55441
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Other Names 2

Doing Business AsRoger Mondale, Dds
Former Legal Business NameRoger Mondale Dds

Other Identifiers 2

Medicaid744487700MN
Medicaid744487700MNMN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Mondale Dental LLC's NPI number?

The NPI number for Mondale Dental LLC is 1053834481. It was assigned to this organization in the NPPES registry on July 18, 2017. The provider is doing business as Roger Mondale, Dds. The provider was formerly known as Roger Mondale DDS.

Where is Mondale Dental LLC located?

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

What is Mondale Dental LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Mondale Dental LLC was last updated on July 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.