Judy K Pedro-Lim, D.M.D., M.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D10662 Issued in MN

Practice address

4640 Slater Rd
Suite 150
Eagan, MN 55122-4043

Phone

(651) 808-5252

Fax

(651) 808-5253

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Judy Pedro-Lim

  dba Eagan Children's Dentistry

  • Pediatric Dentistry
  • Eagan, MN
  • NPI 1316565823
  NPD Authorized official
• Toh-Eng Lim, DDS

  dba Eagan Dental clinic

  • General Practice Dentistry
  • Eagan, MN
  • NPI 1942474457

  Pediatric Dentistry

  NPD (past) Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962574590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 SLATER RD",
            "address_2": "SUITE 150",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224043",
            "telephone_number": "651-808-5252",
            "fax_number": "651-808-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 SLATER RD",
            "address_2": "SUITE 150",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224043",
            "telephone_number": "651-808-5252",
            "fax_number": "651-808-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRO-LIM",
        "first_name": "JUDY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D10662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "485517500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PDG, P.a. (Park Dental)
• Makenna R Pechumer, CNP
• Jennifer Bloedel Pederson, P.T.
• Pediatric and Young Adult Medicine, PA
• Pediatric Phlebotomy Enhanced LLC
• Lisa Diane Peirson, OTR/L
• Heather Amy Penm, LAMFT
• People Incorporated
• Paige Peplinski
• Glenn A Perkins, DDS

• Pediatric Dentistry in Eagan, MN
• Providers in Eagan, MN by specialty
• Pediatric 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.