Lisa Ann Edstrom, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12681 Issued in MN

Practice address

3436 Denmark Ave
Eagan, MN 55123-1088

Phone

(651) 452-4455

NPI assigned

Jun 16, 2009

Last updated

Sep 30, 2020By 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)

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.

• Brite Smiles Dental Care

  • General Practice Dentistry
  • Apple Valley, MN
  • NPI 1437580818
  NPD (past)
• Edstrom & Helgeson, P.a.

  dba Denmark Dental

  • Dental Clinic/Center
  • Eagan, MN
  • NPI 1811401375
  NPD (past)
• Robert a. Casper Jr.,D.D.S., P.a.

  • General Practice Dentistry
  • Eagan, MN
  • NPI 1821218462
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1922235027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 DENMARK AVE",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231088",
            "telephone_number": "651-452-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 DENMARK AVE",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231088",
            "telephone_number": "651-452-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Ebrahim, MD
• Megan Eddy
• Michael Edison, LADC
• Edstrom & Helgeson, P.a. (Denmark Dental)
• Jeanine Marie Edstrom, PAC
• John P Edwards
• Ilhan Egal
• Laura Swanson Eggen, APRN, CNP
• Jason Lavern Eggers, MD, DC
• Kara Ehrman

• Dentist in Eagan, MN
• Providers in Eagan, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.