SOUTHERN HEIGHTS DENTAL GROUP PA
NPI 1932247921
Dentist - General Practice in Faribault, MN

Q: What is Southern Heights Dental Group PA's NPI number?

The NPI number for Southern Heights Dental Group PA is 1932247921. It was assigned to this organization in the NPPES registry on February 2, 2007.

Q: What is Southern Heights Dental Group PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since February 02, 2007

1575 20TH STREET NORTHWEST, SUITE 102, FARIBAULT, MN 55021(507) 334-6433(507) 334-0044 Get Directions Write a Review

NPPES record last updated: August 6, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 6, 2020, Jul 25, 2017, May 25, 2017 and 1 more (4 updates tracked since 2017).

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About Southern Heights Dental Group Pa NPPES

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

SOUTHERN HEIGHTS DENTAL GROUP PA (NPI 1932247921) is a healthcare organization registered as a general practice in Faribault, Minnesota and active in the NPI registry since February 2007. The organization lists Kate Tonjum, Administrator, as its authorized official.

NPPES Registry Identity

NPI1932247921

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameSOUTHERN HEIGHTS DENTAL GROUP PA

Location Address1575 20TH STREET NORTHWEST, SUITE 102Faribault, MN 55021

Mailing Address1575 20th Street Northwest, Suite 102Faribault, MN 55021 · (507) 334-6433 · Fax (507) 334-0044

Phone(507) 334-6433

Fax(507) 334-0044

Organization SubpartNo

Authorized OfficialKate TonjumAdministrator · (507) 334-6433

Enumeration DateFebruary 2, 2007

Last NPPES UpdateAugust 6, 20204 updates tracked since enumeration

NPPES CertifiedAugust 6, 2020

✔ NPI 1932247921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in MN · D7800✔ Licensed in MN · D9884✔ Licensed in MN · D10323✔ Licensed in MN · D11586✔ Licensed in MN · D11400✔ Licensed in MN · D11631✔ Licensed in MN · D8742

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.

Also ListedClinic/Center · DentalTaxonomy 261QD0000X · License D7800 (MN), D13095 (MN)

1575 20TH STREET NORTHWEST, Faribault, MN 55021

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Other Identifiers 9

Medicaid443655000MN

Medicaid607320400MN

Medicaid849698600MN

Medicaid325522100MN

Medicaid550722700MN

Medicaid856415900MN

Medicaid284735300MN

Medicaid148427300MN

Medicaid440217100MN

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

TEDDY J ERICKSON

Dentist (General Practice)