ONE BREAD ONE BODY MD LLC NPI 1083404966

NPI Information

  • NPI: 1083404966
  • Provider Name: ONE BREAD ONE BODY MD LLC
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • Address: 513 CENTRAL AVE N STE 1
    FARIBAULT, MN
    ZIP 55021
  • Phone: (507) 301-7602

Map and Directions

Get Directions

NPI Details

ONE BREAD ONE BODY MD LLC is a dermatology in Faribault, MN. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. ONE BREAD ONE BODY MD LLC NPI is 1083404966. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

513 CENTRAL AVE N STE 1
FARIBAULT, MN
ZIP 55021-322
Phone: (507) 301-7602
Fax: (507) 301-7602

The provider's authorized official is Wendy Bongers .
The authorized official title is Practice Owner and has the following contact phone number (507) 301-7602.

The enumeration date for this NPI number is 5/12/2025 and was last updated on 5/12/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207N00000XDermatologyYes

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: 11/21/2025

NPI Synchronization or Removal

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.