LAKES DERMATOLOGY, PA (NPI# 1962871608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962871608 |
| Entity Type | Organization |
| Organization Name | LAKES DERMATOLOGY, PA |
| Practice Address |
14305 Southcross Dr W Suite 110 Burnsville MN 55306-7009 |
| Mailing Address |
2732 Irving Ave S Suite 110 Minneapolis MN 55408-1049 |
| Practice Telephone | 6123874627 |
| Practice Fax Number | 6123779713 |
| Mailing Telephone | 6123874627 |
| Mailing Fax Number | 6123779713 |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |
| Authorized Official Name | DR. REHANA LEILA AHMED-SAUCEDO (DERMATOLOGIST, PRESIDENT) |
| Authorized Official Telephone | 6123874627 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 51837 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
14305 SOUTHCROSS DR W SUITE 110 |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55306-7009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568095438 | Roers Senior Living Burnsville LLC | Assisted Living Facility | 14401 Grand Avenue, Burnsville, MN 55306 | 2020-02-19 |
| 1639717986 | Kaylee Nadine Frederickson | Speech-Language Pathologist | 14451 Grand Ave S, Burnsville, MN 55306 | 2019-12-17 |
| 1780236893 | Nichole Arn | Occupational Therapist | 14301 Ewing Avenue, Burnsville, MN 55306 | 2019-07-10 |
| 1942708516 | Nicholas John Solverson | Chiropractor | 14671 Chicago Ave Apt 6, Burnsville, MN 55306 | 2018-01-29 |
| 1164978672 | Benjamin Halpern | Dentist | 14344 Burnhaven Drive, Burnsville, MN 55306 | 2016-08-26 |
| 1528478336 | Michael Patrick Hennes | Chiropractor | 14587 Grand Ave Ste 112, Burnsville, MN 55306 | 2014-05-01 |
| 1467799924 | Dentalign, Pa | Dentist | 2999 County Road 42 W Suite 138, Burnsville, MN 55306 | 2013-01-03 |
| 1417205436 | Heather Heide | Student in an Organized Health Care Education/Training Program | 14750 Lac Lavon Dr, Burnsville, MN 55306 | 2012-08-23 |
| 1427243898 | Rehana Leila Ahmed-saucedo | Dermatology | 14305 Southcross Dr, Suite 110, Burnsville, MN 55306 | 2007-09-10 |
| 1881815397 | Kyle James Colbert | Chiropractor | 745 Crystal Lake Rd East, Burnsville, MN 55306 | 2007-05-01 |
| Find all providers in zip 55306 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427243898 | Rehana Leila Ahmed-saucedo | Dermatology | 14305 Southcross Dr, Suite 110, Burnsville, MN 55306 | 2007-09-10 |
| 1144586165 | Joseph Anton Scherman | Dermatology | 14000 Fairview Dr, Burnsville, MN 55337-5713 | 2012-04-03 |
| 1144386392 | Michael John Ebertz | Dermatology | 14000 Nicollet Ave, Suite 304, Burnsville, MN 55337-5790 | 2006-12-29 |
| 1790841989 | Heidi Leigh Foster | Dermatology | 14000 Nicollet Ave, Suite 304, Burnsville, MN 55337-5790 | 2006-12-29 |
| 1619954963 | Michelle M Blaeser | Dermatology | 14000 Fairview Dr, Burnsville, MN 55337-5713 | 2005-12-28 |
| 1336125517 | Victoria Vanroy | Dermatology | 14000 Fairview Dr, Burnsville, MN 55337-5713 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
| 1578982773 | Lori Ann Fiessinger | Dermatology | 420 Delaware Street Se, Mmc 98, Minneapolis, MN 55455 | 2014-04-15 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1033537782 | Erin Sellinger | Dermatology | 2 Carlson Pkwy N, Ste 240, Plymouth, MN 55447-4485 | 2014-03-31 |
| 1033555230 | Samuel Blake Ecker | Dermatology | 3655 Plymouth Blvd Ste 110, Minneapolis, MN 55446-3665 | 2013-05-14 |
| 1295078913 | Jessica Jane Newman | Dermatology | 4-240, Phillips-wangensteen Bldg., 516 Delaware Street S.e., Mail Code 98, Minneapolis, MN 55455 | 2013-04-01 |
| 1437416088 | Tiffany Lynn Shih | Dermatology | 401 Phalen Blvd # Ms 41102b, Saint Paul, MN 55130-5302 | 2012-04-20 |
| 1124317383 | Sara Anne Hylwa | Dermatology | 730 South 8th Street, Department of Dermatology, Minneapolis, MN 55415 | 2011-03-28 |
| 1770885360 | Thomas Joseph Kalb | Dermatology | 13420 106th St., Young America, MN 55397-5401 | 2010-12-02 |
| 1346550092 | John D Sarbacker | Dermatology | 1216 23rd Ave S, Moorhead, MN 56560-4536 | 2010-10-15 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55306 |
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| 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.