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CRYSTAL DENTAL CLINIC LLC
NPI 1386479657
Dentist - General Practice in Rochester, MN

Active since September 05, 2024
1812 2ND ST SW, ROCHESTER, MN 55902(507) 208-4141(507) 229-1001 Get Directions Write a Review

NPPES record last updated: September 5, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Crystal Dental Clinic Llc NPPES

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

CRYSTAL DENTAL CLINIC LLC (NPI 1386479657) is a healthcare organization registered as a general practice in Rochester, Minnesota and active in the NPI registry since September 2024. The organization lists Michelle Theede, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1386479657
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCRYSTAL DENTAL CLINIC LLC
Location Address1812 2ND ST SWRochester, MN 55902-4127
Mailing Address1812 2nd St SwRochester, MN 55902-4127 · (507) 208-4141 · Fax (507) 229-1001
Phone(507) 208-4141
Fax(507) 229-1001
Organization SubpartNo
Authorized OfficialMichelle TheedeOffice Manager · (507) 208-4141
Enumeration DateSeptember 5, 2024
NPPES CertifiedSeptember 5, 2024
✔ NPI 1386479657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

1812 2ND ST SW, Rochester, MN 55902
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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.

DR. PARABHAJOT VASDEV DMD
Dentist
1812 2ND ST SW
ROCHESTER, MN 55902
Olmsted County (507) 208-4141
PHOENIX HEALING CENTER LLC
Clinic/Center (Adult Mental Health)
1812 2ND ST SW, SUITE F
ROCHESTER, MN 55902
Olmsted County (507) 322-0222
NICOLE MARIE SALERNO
Clinic/Center (Student Health)
1812 2ND ST SW
ROCHESTER, MN 55902
Olmsted County (507) 208-4141

Frequently Asked Questions

What is CRYSTAL DENTAL CLINIC LLC's NPI number?

The NPI number assigned to this healthcare provider is 1386479657, enumerated as an "organization" on September 05, 2024.

Where is the provider located?

The provider is located at 1812 2ND ST SW ROCHESTER, MN 55902 and the phone number is (507) 208-4141.

What is the provider's specialty?

Dentist with taxonomy code 1223G0001X and a focus in General Practice.