Kimberly Ellen Rostvold, DDS
NPI 1417479700ActiveIndividual· Dentist, Pediatric Dentistry· Hermantown, MN
Dentist, Pediatric Dentistry (DDS) in Hermantown, Minnesota, licensed in MN and PA, with an NPI issued in July 2017. Enrolled in Medicare as practitioner - dentist.
Overview
| NPI | 1417479700 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | No |
| NPI issued | Jul 9, 2017 |
| Last updated in NPPES | Jun 16, 2025 |
| Certified by provider | Jun 16, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | D14233 | MN |
| Dentist | 122300000X | D14233 | MN |
| Dentist | 122300000X | DS041402 | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Dentist (MN) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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