Jade Lyles, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13034 Issued in MN

Practice address

8353 Crystal View Rd
Eden Prairie, MN 55344-7324

Phone

(952) 252-4000

NPI assigned

Aug 21, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northland Dental Partners, PLLC

  dba Metro Dentalcare Eden Prairie

  • General Practice Dentistry
  • Eden Prairie, MN
  • NPI 1700534138
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1184856320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8353 CRYSTAL VIEW RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447324",
            "telephone_number": "952-252-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8353 CRYSTAL VIEW RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447324",
            "telephone_number": "952-252-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "JADE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13034",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen George Lutz, MD
• Gordon Luu, DDS
• Luxottica of America Inc (Target Optical #C4111)
• Luxottica of America Inc. (LensCrafters #2701)
• Justin Q. Ly, M.D.
• Cory Thomas Lymburner, MD
• Matthew Lynn, OTR/L
• Chelsea Maag, AU.D.
• Alice Macdonald, MBCHB
• Christopher James Macdonald, MD, PHD

• General Practice Dentistry in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.