NPIMap

Organization Active NPI

Oakdale Ear, Nose & Throat Clinic, P.a.

Doing business as Minnesota ENT

  • Otolaryngology Physician
  • Golden Valley, MN
National Provider Identifier
1598976326
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
OAKDALE EAR, NOSE & THROAT CLINIC, P.A.
Doing business as
Minnesota ENT
Practice address
8301 Golden Valley Rd Ste 200
Golden Valley, MN 55427-4435
Phone
(763) 233-5755
Fax
(763) 233-5782
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Marya C Lydeen
Title
Practice Administrator
Phone
(763) 233-5775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

8301 Golden Valley Rd Ste 200
Golden Valley, MN 55427-4435

Mailing address

8301 Golden Valley Rd Ste 200
Golden Valley, MN 55427-4475
Phone (763) 233-5755

Other practice location 1

3366 Oakdale Ave N Ste 150
Robbinsdale, MN 55422-2961
Phone (763) 233-5755

Other practice location 2

9825 Hospital Dr Ste 203
Maple Grove, MN 55369-4772
Phone (763) 233-5755

Other names 1

  • Minnesota ENT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000132 MN Part B Supplier - Clinic/Group Practice 9133209802 Receives reassigned benefits from 12 practitioners
Practice locations: Buffalo, MN; Golden Valley, MN; Maple Grove, MN; Robbinsdale, MN

National Provider Directory

National Provider Directory

Locations

8301 Golden Valley Rd
Ste 200
Minneapolis, MN 55427
Phone (763) 233-5755

2855 Campus Dr
Ste 630
Plymouth, MN 55441
Phone (763) 233-5755

3366 Oakdale Ave N
Ste 150
Robbinsdale, MN 55422
Phone (763) 233-5755

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1598976326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 GOLDEN VALLEY RD STE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274475",
            "telephone_number": "763-233-5755",
            "fax_number": "763-233-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 GOLDEN VALLEY RD STE 200",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274435",
            "telephone_number": "763-233-5755",
            "fax_number": "763-233-5782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3366 Oakdale Ave N Ste 150",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222961",
            "country_code": "US",
            "telephone_number": "763-233-5755",
            "fax_number": "763-233-5782",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9825 Hospital Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694772",
            "country_code": "US",
            "telephone_number": "763-233-5755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OAKDALE EAR, NOSE & THROAT CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "LYDEEN",
        "authorized_official_first_name": "MARYA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "763-233-5775"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnesota ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.