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DR. GARY ROBERT JERNBERG D.D.S., M.S.D.
NPI 1164420675
Dentist - Periodontics in Mankato, MN

Active since July 08, 2005
99 NAVAHO AVE, SUITE 102, MANKATO, MN 56001(507) 345-7537(507) 345-7538 Get Directions Write a Review

NPPES record last updated: January 28, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Gary Robert Jernberg D.d.s., M.s.d. NPPES

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

DR. GARY ROBERT JERNBERG D.D.S., M.S.D. (NPI 1164420675) is an individual periodontics provider in Mankato, Minnesota, licensed in Minnesota (8671) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1164420675
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. GARY ROBERT JERNBERGCredential: D.D.S., M.S.D.
Location Address99 NAVAHO AVE, SUITE 102Mankato, MN 56001-4876
Mailing Address99 Navaho Ave, Suite 102Mankato, MN 56001-4876 · (507) 345-7537 · Fax (507) 345-7538
Phone(507) 345-7537
Fax(507) 345-7538
Sole ProprietorYes
Enumeration DateJuly 8, 2005
Last NPPES UpdateJanuary 28, 2011
✔ NPI 1164420675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in MN · 8671
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
99 NAVAHO AVE, Mankato, MN 56001
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Other Identifiers 5

Other1B005JEMN · Bcbs Of Mn
Medicare UPINU51050MN
Other839878PA · United Concordia Military
Medicare ID-Type Unspecified199000257MN
Medicaid434218600MN

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHERN MINNESOTA PERIODONTICS PA
Dentist (Periodontics)
99 NAVAHO AVE, SUITE #102
MANKATO, MN 56001
Blue Earth County (507) 345-7537
SOUTHERN MINNESOTA PERIODONTICS, PA
Dentist (Periodontics)
99 NAVAHO AVE, SUITE 102
MANKATO, MN 56001
Blue Earth County (507) 345-7537
GARY R. JERNBERG, D.D.S., M.S.D.
Dentist (Periodontics)
99 NAVAHO AVE, SUITE 102
MANKATO, MN 56001
Blue Earth County (507) 345-7537

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 Gary Jernberg's NPI number?

The NPI number for Gary Jernberg is 1164420675. It was assigned to this individual provider in the NPPES registry on July 8, 2005.

Where is Gary Jernberg located?

Gary Jernberg practices at 99 Navaho Ave Suite 102, Mankato, MN 56001. The listed phone number is (507) 345-7537.

What is Gary Jernberg's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Gary Jernberg was last updated on January 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.