Jodi Lynn Dezale, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7929 Issued in MN

Practice address

3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422-4298

Phone

(763) 520-0714

Fax

(763) 520-0355

NPI assigned

Mar 14, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Associated Speech and Language Specialists LLC

  • Speech-Language Pathologist
  • St Paul, MN
  • NPI 1881636223
  Medicare reassignment
• Associated Speech and Language

  • Hearing and Speech Clinic/Center
  • Arden Hills, MN
  • NPI 1003188749
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962535245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224298",
            "telephone_number": "763-520-0714",
            "fax_number": "763-520-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224298",
            "telephone_number": "763-520-0714",
            "fax_number": "763-520-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZALE",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MINNESOTA",
            "identifier": "083HIDE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4600930",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP56680",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naajee Dennis
• Dental Partners of Minnesota, LTD
• Jenny Tessa Derasmi, COTA/L
• Laura Deshotels, PT, DPT
• Carley Ellen Devee, PHARMD
• Dianne L. Como, DC, PA
• Andrea Dickinson
• John Kent Dickson, RPH
• Lori Dickson, RPH
• Benjamin Alan Dingman

• Speech-Language Pathologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Speech-Language Pathologist 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.