Provider Type Icon

EDINA FAMILY DENTAL ASSOC. P.A. NPI 1033279393


NPI Information

NPI: 1033279393
Provider Name: EDINA FAMILY DENTAL ASSOC., P.A.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 24D0665177

Address:
4954 LINCOLN DR
EDINA, MN
ZIP 55436
Phone: (952) 935-3532
Get Directions

EDINA FAMILY DENTAL ASSOC., P.A. is a general practice dentist in Edina, MN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. EDINA FAMILY DENTAL ASSOC., P.A. NPI is 1033279393. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4954 LINCOLN DR
EDINA, MN
ZIP 55436-071
Phone: (952) 935-3532

The provider's authorized official is Virgil M Mylan .
The authorized official title is President and has the following contact phone number (952) 935-3532.

The CLIA number assigned to this NPI record is 24D0665177 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/9/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice8250MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.