Kovanda Plastic Surgery, PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

41657 Issued in MN

Legal business name

KOVANDA PLASTIC SURGERY, PLLC

Practice address

4999 France Ave S Ste 210
Edina, MN 55410-2168

Phone

(612) 335-9032

NPI assigned

May 8, 2009

Organization subpart

No

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

Authorized official

Name

Christopher John Kovanda, M.D.

Title

Sole Member

Phone

(763) 416-0676

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1447484159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N",
            "address_2": "SUITE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694200",
            "telephone_number": "763-416-0676",
            "fax_number": "763-416-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4999 FRANCE AVE S STE 210",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554102168",
            "telephone_number": "612-335-9032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9325 Upland Ln N",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694200",
            "country_code": "US",
            "telephone_number": "763-416-0676",
            "fax_number": "763-416-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOVANDA PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "KOVANDA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "763-416-0676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "41657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  INDIVIDUAL",
            "identifier": "1861501082",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852226000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Vadimovich Kornel, LAC
• George Matthen Koshy, M.D.
• Robin Koska, CES, OTR/L
• Abigail Rose Koski, DO
• Larry William Kotek, M.D.
• Christopher J Kovanda, MEDICAL DOCTOR
• Aubrey Krahn, PT
• David M Krakowski I
• Jill Anne Kramer, MSSW, LICSW
• Michael Thomas Kratz, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.