Active NPI
Lisa Fedor James, D.D.S
- Prosthodontics
- Minneapolis, MN
National Provider Identifier
1316110067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- D11557
- Practice address
- 516 Delaware St SE
7-300 PWB
Minneapolis, MN 55455-0356 - Phone
- (612) 626-4232
- Fax
- (612) 626-1972
- NPI assigned
- Apr 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | D11557 | MN | Primary |
Addresses
Primary practice location
516 Delaware St SE
7-300 PWB
Minneapolis, MN 55455-0356
Mailing address
516 Delaware St SE
7-300 PWB
Minneapolis, MN 55455-0356
Phone (612) 626-4232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11557 | MN | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1316110067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "7-300 PWB",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550356",
"telephone_number": "612-626-4232",
"fax_number": "612-626-1972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 DELAWARE ST SE",
"address_2": "7-300 PWB",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550356",
"telephone_number": "612-626-4232",
"fax_number": "612-626-1972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "LISA",
"middle_name": "FEDOR",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-02",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MN",
"license": "D11557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.