Minnesota Ophthalmic Plastic Surgery Specialists, P.C.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

33370 Issued in MN

Legal business name

MINNESOTA OPHTHALMIC PLASTIC SURGERY SPECIALISTS, P.C.

Practice address

6405 France Ave S Ste W460
Edina, MN 55435-2189

Phone

(952) 925-4161

Fax

(952) 925-3520

NPI assigned

Dec 13, 2017

Organization subpart

No

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

Authorized official

Name

Tori Dodge

Title

Clinic Administrator

Phone

(952) 925-4161

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1427563386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S STE W460",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352189",
            "telephone_number": "952-925-4161",
            "fax_number": "952-925-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S STE W460",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352189",
            "telephone_number": "952-925-4161",
            "fax_number": "952-925-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA OPHTHALMIC PLASTIC SURGERY SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "TORI",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "952-925-4161"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "33370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmic Plastic and Reconstructive Surgery Physician in Edina, MN
• Providers in Edina, MN by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.