OrganizationActive
Southern Minnesota Periodontics, PA
NPI 1609012624 · Periodontics · Mankato, MN
Southern Minnesota Periodontics, PA is a Periodontics organization in Mankato, MN (NPI 1609012624).
Provider details
- NPI number
- 1609012624
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Gary Jernberg, Owner(507) 345-7537
- License
- 11710 (MN)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
99 Navaho Ave
Suite 102
Mankato, MN 56001-4876
Phone: (507) 345-7537
Fax: (507) 345-7538
Street-level locationGet directions
Mailing address
99 Navaho Ave
Mankato, MN 56001-4876
Registry dates
- Enumerated
- 2008-12-22
- Last updated
- 2008-12-22
Frequently asked questions
- What is Southern Minnesota Periodontics, PA's NPI number?
- Southern Minnesota Periodontics, PA's National Provider Identifier (NPI) is 1609012624, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Minnesota Periodontics, PA?
- Southern Minnesota Periodontics, PA is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Southern Minnesota Periodontics, PA located?
- Southern Minnesota Periodontics, PA's practice location on file with NPPES is 99 Navaho Ave, Mankato, MN 56001-4876.
- What is Southern Minnesota Periodontics, PA's phone number?
- The practice phone number listed in the NPPES registry for Southern Minnesota Periodontics, PA is (507) 345-7537.
- Who is the authorized official for Southern Minnesota Periodontics, PA?
- The authorized official listed on Southern Minnesota Periodontics, PA's NPPES record is Gary Jernberg, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Minnesota Periodontics, PA's NPI active?
- Yes — Southern Minnesota Periodontics, PA's NPI (1609012624) is active in the NPPES registry as of the last update on 2008-12-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.