Individual provider Active NPI

Lisa Murray, D.D.S.

  • General Practice Dentistry
  • Fridley, MN
National Provider Identifier
1932166816
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10520 Issued in MN
Practice address
6230 Highway 65 NE
#105
Fridley, MN 55432-5107
Phone
(763) 571-5497
NPI assigned
Apr 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10520 MN Primary

Addresses

Primary practice location

6230 Highway 65 NE
#105
Fridley, MN 55432-5107

Mailing address

6230 Highway 65 NE
#105
Fridley, MN 55432-5107
Phone (763) 571-5497

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170620002802 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7810170669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10520MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Lake Dental Past Accepting new patients
Steady Dental General Practice PastSince Sep 21, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1932166816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 HIGHWAY 65 NE",
            "address_2": "#105",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325107",
            "telephone_number": "763-571-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 HIGHWAY 65 NE",
            "address_2": "#105",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325107",
            "telephone_number": "763-571-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.