Active NPI
Stephanie Dykema
- Diagnostic Radiology Physician
- Woodbury, MN
National Provider Identifier
1861904765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 572405
- Practice address
- 6809 Sandlewood Rd
Woodbury, MN 55125-2175 - Phone
- (701) 260-2298
- NPI assigned
- Oct 31, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 572405 | MN | Primary |
Addresses
Primary practice location
6809 Sandlewood Rd
Woodbury, MN 55125-2175
Mailing address
6809 Sandlewood Rd
Woodbury, MN 55125-2175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 572405 | MN | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509408000000",
"number": "1861904765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6809 SANDLEWOOD RD",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6809 SANDLEWOOD RD",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252175",
"telephone_number": "701-260-2298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKEMA",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-31",
"last_updated": "2017-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "572405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.