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MDO PERIODONTICS PA
NPI 1558516369
Dentist - Periodontics in Sartell, MN

Active since November 20, 2008
1900 KRUCHTEN CT S, STE. 101, SARTELL, MN 56377(320) 240-9028(320) 240-9048 Get Directions Write a Review

NPPES record last updated: November 20, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mdo Periodontics Pa NPPES

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

MDO PERIODONTICS PA (NPI 1558516369) is a healthcare organization registered as a periodontics in Sartell, Minnesota and active in the NPI registry since November 2008. The organization lists Michelle Grundhoefer, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1558516369
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameMDO PERIODONTICS PA
Location Address1900 KRUCHTEN CT S, STE. 101Sartell, MN 56377-4730
Mailing Address1900 Kruchten Ct S, Ste. 101Sartell, MN 56377-4730 · (320) 240-9028 · Fax (320) 240-9048
Phone(320) 240-9028
Fax(320) 240-9048
Organization SubpartNo
Authorized OfficialMichelle GrundhoeferOffice Manager · (320) 240-9028
Enumeration DateNovember 20, 2008
✔ NPI 1558516369 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.
1900 KRUCHTEN CT S, Sartell, MN 56377
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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

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

CENTRAL MINNESOTA ENDODONTICS, PA
Dentist (Endodontics)
1900 KRUCHTEN CT S, SUITE 100
SARTELL, MN 56377
Stearns County (320) 656-1456

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 Mdo Periodontics PA's NPI number?

The NPI number for Mdo Periodontics PA is 1558516369. It was assigned to this organization in the NPPES registry on November 20, 2008.

Where is Mdo Periodontics PA located?

Mdo Periodontics PA is located at 1900 Kruchten Ct S Ste. 101, Sartell, MN 56377. The listed phone number is (320) 240-9028.

What is Mdo 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 Mdo Periodontics PA was last updated on November 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.