MINNESOTA CRANIOFACIAL CENTER P.C. (NPI# 1104160480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104160480 |
| Entity Type | Organization |
| Organization Name | MINNESOTA CRANIOFACIAL CENTER P.C. |
| Practice Address |
2550 University Ave W Suite 143n Saint Paul MN 55114-1052 |
| Practice Telephone | 6516421013 |
| Practice Fax Number | 6516420947 |
| Mailing Telephone | 6516421013 |
| Mailing Fax Number | 6516420947 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2015-06-11 |
| Authorized Official Name | DR. KIM MARIE LEDERMANN (DENTIST/OWNER) |
| Authorized Official Telephone | 6516421013 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 11715 | MN | Ambulatory Health Care Facilities |
| Street Address |
2550 UNIVERSITY AVE W SUITE 143N |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747143 | Colleen Rae Caspers | Nurse Practitioner | 2550 University Ave W, Suite 423 South, Saint Paul, MN 55114-1052 | 2005-08-11 |
| 1538707484 | Hannah Weaver | Nutritionist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-12-11 |
| 1881251114 | Miriam Rebecca Koch Gerber | Psychologist | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-05-22 |
| 1578036042 | Sarah Lazarewicz | Social Worker | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2019-01-08 |
| 1215443049 | Frederick Marcus Vickery | Counselor | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2017-12-15 |
| 1790222438 | Plastic Surgery Consultants | Plastic Surgery | 2550 University Ave W, Ste 110n, Saint Paul, MN 55114-1052 | 2017-01-19 |
| 1720537350 | Kulule H Kenea | Nurse Practitioner | 2550 University Ave W, Suite 325s, Saint Paul, MN 55114-1052 | 2016-09-23 |
| 1992250187 | Erin Ziolkowski | Dietitian, Registered | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-08-17 |
| 1396196655 | Alyssa Greene | Counselor | 2550 University Ave W, Saint Paul, MN 55114-1052 | 2016-06-28 |
| 1194174854 | Accessible Space, Inc. | Respite Care | 2550 University Ave W, Suite 330n, Saint Paul, MN 55114-1052 | 2016-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 1740849454 | Bilterms Solutions Inc | Clinic/Center | 2430 University Ave W, Saint Paul, MN 55114-1706 | 2019-06-07 |
| 1215334578 | St Paul Clinic LLC | Clinic/Center | 301 University Ave W, Saint Paul, MN 55103-2048 | 2014-12-02 |
| 1518192798 | Family Eyecare Pa | Clinic/Center | 2309 Como Ave, Saint Paul, MN 55108-1723 | 2009-05-18 |
| 1871779595 | Associated Hearing Instruments of St Paul Inc | Clinic/Center | 393 Dunlap St N Ste 115, Saint Paul, MN 55104-4203 | 2008-01-11 |
| 1932389897 | Dr. Bobby K. Yang M.d. Medical Clinic, LLC | Clinic/Center | 1047 University Ave W, Suite 101, Saint Paul, MN 55104-4751 | 2007-11-08 |
| 1346302981 | St. Paul Family Medical Center | Clinic/Center | 1239 Payne Ave, Saint Paul, MN 55130 | 2006-12-13 |
| 1942384193 | United Family Practice Health Center | Clinic/Center | 1307 Maynard Dr W, Suite 13, Saint Paul, MN 55116-2930 | 2006-10-24 |
| 1235755349 | Abundant Life Health Coaches, LLC | Clinic/Center | 808 Berry St Apt 237, Saint Paul, MN 55114-1474 | 2020-06-24 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
Please comment or provide details below to improve the information on MINNESOTA CRANIOFACIAL CENTER P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.