Laurie Lee Stodola, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11396 Issued in MN

Practice address

12425 55TH St N
Lake Elmo, MN 55042-7403

Phone

(651) 430-1020

Fax

(651) 439-2201

NPI assigned

Jul 7, 2006

Last updated

Sep 23, 2013By 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mahtomedi Dental P.C.

  dba Grace Dental

  • Dentist
  • Lake Elmo, MN
  • NPI 1275969263
  NPD (past) Authorized official

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1831121045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 55TH ST N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550427403",
            "telephone_number": "651-430-1020",
            "fax_number": "651-439-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 55TH ST N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550427403",
            "telephone_number": "651-430-1020",
            "fax_number": "651-439-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODOLA",
        "first_name": "LAURIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Croix Anesthesia Associates, P.a.
• St. Croix Counseling
• St. Croix Orthopaedics, P.a.
• Stanley J. Antolak Jr. MD PA (Center for Urologic and Pelvic Pain)
• Steady Strides LLC
• Hannah Strom, PT
• Alison Mae Stroobants, MPS, LPCC, LADC
• Sututa Home Healthcare Services LLC
• Anna Swanson, LICSW
• Margit Alice Swanson, PSYD

• General Practice Dentistry in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.