Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Minnesota Periodontics, PA

Organization Periodontics · NPI 1609012624

Southern Minnesota Periodontics, PA is a Periodontics in Mankato, Minnesota. Licensed in Minnesota. Registered with an NPI since 2008.

Licensed in
MN
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

99 Navaho Ave Ste 102
Mankato, MN 56001-4876
Phone: (507) 345-7537
Fax: (507) 345-7538
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 8671 (MN)
Periodontics Taxonomy 1223P0300X · Licence 11710 (MN)

Record details

NPI number1609012624
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Jernberg — Owner · (507) 345-7537
NPI enumeratedDecember 22, 2008
Last updated in NPPESDecember 22, 2008
Mailing address99 Navaho Ave, Suite 102, Mankato, MN 56001-4876

Other providers in Mankato