Daniel Trajano

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

39445 Issued in MN

Practice address

4670 Park Nicollet Ave SE
Prior Lake, MN 55372-3908

Phone

(952) 993-7750

NPI assigned

Dec 15, 2005

Last updated

Mar 8, 2012By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1437135118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "CREDENTIALING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723908",
            "telephone_number": "952-993-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAJANO",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "39445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Thompson, RN
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• Gillian Tibbetts, PSYD
• Tonya Wilhelm Therapy and Consulting PA (Wilhelm Therapy & Consulting)
• Touching Lives Community, Inc.
• Nicole Lynn Ulrich, D.O.
• Karen Van Rooyen
• Jessica A Vanderscoff, MD
• Amy Wander, RN, LSN
• Magdalena Eva Warren, DNP, FNP-C

• Geriatric Medicine (Family Medicine) Physician in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Geriatric Medicine (Family Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.