Dylla-Jensen Periodontics PLLC
Dentist, Periodontics in Edina, MN. Organization (NPI-2).
NPI number1407008477
StatusActive
Last updated in NPPESOct 21, 2008
Details
- NPI
- 1407008477
- Entity type
- Organization (NPI-2)
- Legal business name
- Dylla-Jensen Periodontics PLLC
- Organization subpart
- No
- Enumeration date
- Oct 21, 2008
- Last updated
- Oct 21, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | – | – | Yes |
Practice location
6545 France Ave SEdina, MN 55435-2131
Phone 952-922-6949 · Fax 952-922-9287
Mailing address
6545 France Ave SEdina, MN 55435-2131
Phone 952-922-6949
Authorized official
Russell Dylla
D.D.S.
9529226949
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Other Periodontics providers in Edina, MN
- Russell Allen Dylla, DDSNPI 1710180294
- Jonathan M Jenkins, D.D.S., M.D.NPI 1285795500
- James R Jensen, D.D.S., M.D.NPI 1780745091
- Jerod Thomas Klava, DDSNPI 1205129012
- Donald E. Lareau, D.D.S., M.S.NPI 1861575946
- Douglas George Petersen, DDSNPI 1134208630
- Oender Solakoglu, D.D.S., M.S., PH.D.NPI 1811058126
- Southdale PeriodonticsNPI 1326044538
- Southdale Periodontics, PLLCNPI 1134547730
- Larry F Wolff, D.D.S., PH.D.NPI 1629166350
All 11 Periodontics providers in Edina · All 4,659 providers in Edina
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