SOUTHERN MINNESOTA PERIODONTICS PA
NPI 1316390669
Dentist - Periodontics in Mankato, MN

Active since July 21, 2016
99 NAVAHO AVE, SUITE #102, MANKATO, MN 56001(507) 345-7537(507) 345-7538 Get Directions Write a Review

NPPES record last updated: July 22, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southern Minnesota Periodontics Pa NPPES

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

SOUTHERN MINNESOTA PERIODONTICS PA (NPI 1316390669) is a healthcare organization registered as a periodontics in Mankato, Minnesota and active in the NPI registry since July 2016. The organization lists Sergey Borisovich Dolgov, Owner, as its authorized official.

NPPES Registry Identity

NPI1316390669
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameSOUTHERN MINNESOTA PERIODONTICS PA
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
Fax(507) 345-7538
Organization SubpartNo
Authorized OfficialSergey Borisovich DolgovOwner · (786) 487-1190
Enumeration DateJuly 21, 2016
Last NPPES UpdateJuly 22, 2016
NPI 1316390669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
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

Other Identifiers 1

Medicare PINH400256296MN

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

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.

Dentist (Periodontics)
99 NAVAHO AVE, SUITE 102
MANKATO, MN 56001
Dentist (Periodontics)
99 NAVAHO AVE, SUITE 102
MANKATO, MN 56001
Dentist (Periodontics)
99 NAVAHO AVE, SUITE 102
MANKATO, MN 56001

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 Southern Minnesota Periodontics PA's NPI number?

The NPI number for Southern Minnesota Periodontics PA is 1316390669. It was assigned to this organization in the NPPES registry on July 21, 2016.

Where is Southern Minnesota Periodontics PA located?

Southern Minnesota Periodontics PA is located at 99 Navaho Ave Suite #102, Mankato, MN 56001. The listed phone number is (507) 345-7537.

What is Southern Minnesota Periodontics PA'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 Southern Minnesota Periodontics PA was last updated on July 22, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.