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ROCHESTER PEDIATRIC DENTISTRY LLC
NPI 1609272822
Clinic/Center - Dental in Rochester, MN

Active since November 16, 2014
1705 S BORADWAY AVE STE B, ROCHESTER, MN 55904(507) 288-0102(507) 252-1445 Get Directions Write a Review

NPPES record last updated: December 8, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 8, 2020, Sep 23, 2020 (2 updates tracked since 2020).

About Rochester Pediatric Dentistry Llc NPPES

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

ROCHESTER PEDIATRIC DENTISTRY LLC (NPI 1609272822) is a healthcare organization registered as a dental in Rochester, Minnesota and active in the NPI registry since November 2014. The organization lists Kelly Amanda Jones, Pediatric Dentist, Owner, as its authorized official.

NPPES Registry Identity

NPI1609272822
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameROCHESTER PEDIATRIC DENTISTRY LLC
Location Address1705 S BORADWAY AVE STE BRochester, MN 55904-7960
Mailing Address1705 S Boradway Ave Ste BRochester, MN 55904-7960 · (507) 288-0102 · Fax (507) 252-1445
Phone(507) 288-0102
Fax(507) 252-1445
Organization SubpartNo
Authorized OfficialKelly Amanda JonesPediatric Dentist, Owner · (608) 206-1233
Enumeration DateNovember 16, 2014
Last NPPES UpdateDecember 8, 20202 updates tracked since enumeration
NPPES CertifiedDecember 8, 2020
✔ NPI 1609272822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
Also ListedDentist · Pediatric DentistryTaxonomy 1223P0221X · License D13120 (MN)
1705 S BORADWAY AVE STE B, Rochester, MN 55904
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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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 Rochester Pediatric Dentistry LLC's NPI number?

The NPI number for Rochester Pediatric Dentistry LLC is 1609272822. It was assigned to this organization in the NPPES registry on November 16, 2014.

Where is Rochester Pediatric Dentistry LLC located?

Rochester Pediatric Dentistry LLC is located at 1705 S Boradway Ave Ste B, Rochester, MN 55904. The listed phone number is (507) 288-0102.

What is Rochester Pediatric Dentistry LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Rochester Pediatric Dentistry LLC was last updated on December 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.