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

Payton Lee Pendergast, DT

Individual provider Dental Therapist · NPI 1265324388

Payton Lee Pendergast, DT is a Dental Therapist in Mankato, Minnesota. Licensed in Minnesota. Registered with an NPI since 2025.

Licensed in
MN
In the registry since
2025

Practice location Address checks out

309 Holly Ln
Mankato, MN 56001-5422
Phone: (507) 388-2120
Show map & directions

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

Specialties & licences

Dental Therapist (primary) Taxonomy 125J00000X · Licence DT189 (MN)

Record details

NPI number1265324388
Entity typeIndividual (Type 1)
GenderFemale
Credentials DT
Sole proprietorNo
NPI enumeratedJuly 15, 2025
Last updated in NPPESOctober 13, 2025
Certification dateOctober 13, 2025

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