Dylla-Jensen Periodontics PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

DYLLA-JENSEN PERIODONTICS PLLC

Practice address

6545 France Ave S
Edina, MN 55435-2131

Phone

(952) 922-6949

Fax

(952) 922-9287

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Russell Dylla, D.D.S.

Title

D.D.S.

Phone

(952) 922-6949

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1407008477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-922-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-922-6949",
            "fax_number": "952-922-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYLLA-JENSEN PERIODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "DYLLA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "D.D.S.",
        "authorized_official_telephone_number": "952-922-6949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa K Dvorak, PA
• Paul G Dworak, M.D.
• Laura Dwyer, LMFT
• Sean Sullivan Dwyer, PA-C
• Derek S Dyess, M.D.
• Russell Allen Dylla, DDS
• Arnela Dzihic
• E-Quip Inc
• Mary Eaton, M.D.
• Jody Eberman, RN

• Periodontics in Edina, MN
• Providers in Edina, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.