Brenna Dedeker

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9605 Issued in MN

Practice address

434 Hayward Ave N
Oakdale, MN 55128-5379

Phone

(651) 739-2300

Fax

(651) 739-2302

NPI assigned

Jan 14, 2016

Last updated

Oct 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Center for Speech, Language and Learning, Inc.

  dba Center for Speech Language Lea

  • Speech-Language Pathologist
  • Oakdale, MN
  • NPI 1164588307
  Medicare reassignment NPD
• Family Quality Care, Inc

  • Home Health Agency
  • Minneapolis, MN
  • NPI 1730392713
  NPD
• Center for Speech, Language, and Learning, Inc.

  • Hearing and Speech Clinic/Center
  • Oakdale, MN
  • NPI 1588592471
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1417313859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 HAYWARD AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285379",
            "telephone_number": "651-739-2300",
            "fax_number": "651-739-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 HAYWARD AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285379",
            "telephone_number": "651-739-2300",
            "fax_number": "651-739-2302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10273 Yellow Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553439144",
            "country_code": "US",
            "telephone_number": "952-401-9359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Baker Rd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553455901",
            "country_code": "US",
            "telephone_number": "612-500-6750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDEKER",
        "first_name": "BRENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Dalen
• Raja David, PSY.D.
• Danyel Davis
• Emma Claire Davis, MSW, LICSW
• Dba See Moua Translation Services
• Adam Paul Delaforest, D.C.
• Heather Marie Demko, MSW, LICSW
• Michelle F Demulling, RN
• Barbara S Denson, LPN
• Tyler Jordan Depaulis, DC

• Speech-Language Pathologist in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.