Lisa Jane Cepek, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12168 Issued in MN

Practice address

4000 Central Ave NE Ste 308
Columbia Heights, MN 55421-2971

Phone

(763) 781-7475

Fax

(763) 781-0828

NPI assigned

Dec 15, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• PDG, P.a.

  dba Park Dental

  • General Practice Dentistry
  • Columbia Heights, MN
  • NPI 1285700302
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871655894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3337 BROWNLOW AVE",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554264217",
            "telephone_number": "952-240-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL AVE NE STE 308",
            "city": "COLUMBIA HEIGHTS",
            "state": "MN",
            "postal_code": "554212971",
            "telephone_number": "763-781-7475",
            "fax_number": "763-781-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPEK",
        "first_name": "LISA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cole Burns
• Candace C Christen, OD, PA
• Carepoint Dental
• Hans Michael Castro, D.C.
• Central Chiropractic Clinic, PLC
• Jingyuan Chen, M.A.
• Chinese Social Service Center
• Chris Frank Counseling (Silver Lake Counseling LLC)
• Jessica Christine Churchill, CCC-SLP
• Columbia Heights Dentistry, PC (Columbia Heights Dentistry)

• General Practice Dentistry in Columbia Heights, MN
• Providers in Columbia Heights, 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 Jul 8, 2007; 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.