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

Dr. Mark Allen Roettger, DDS

Individual provider Dentist · NPI 1356325906

Dr. Mark Allen Roettger, DDS is a Dentist in Lake Elmo, Minnesota. Graduated from University of Minnesota School of Dentistry in 1982, 44 years ago. Licensed in Minnesota.

Years since qualifying
44
Trained at
University of Minnesota School of Dentistry
Licensed in
MN
In the registry since
2005
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12425 55th St N Ste B
Lake Elmo, MN 55042-4450
Phone: (651) 439-0322
Fax: (651) 439-2201
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 9426 (MN)

Record details

NPI number1356325906
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedDecember 6, 2005
Last updated in NPPESMay 11, 2011
Mailing address12425 55th Street N, Suite B, Lake Elmo, MN 55042-4450

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolUNIVERSITY OF MINNESOTA SCHOOL OF DENTISTRY
Graduated 1982 (44 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Lake Elmo