Dykstra, Dennis Dale

Dykstra, Dennis Dale is an individual health care provider with primary practice located at 516 Delaware Street Se Pwb 1St Fl Clinic 1A University Of Minnesota Physicians, Minneapolis MN 55455. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Dykstra, Dennis Dale can be contacted via phone (612) 626-6688.

Contact Information

Primary practice address
516 Delaware Street Se Pwb 1St Fl Clinic 1A University Of Minnesota Physicians Minneapolis MN 55455
Phone: (612) 626-6688
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 26055 Minnesota
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 26055 Minnesota

Profile Details

NPI number 1376571950
LBN Legal business name Dykstra, Dennis Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Oct 25th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376571950 NPPES
Minnesota Other 2T420DY BCBS
Minnesota Other 23-24496 BCBS
Minnesota MEDICAID 075203700 BCBS
Minnesota Other 1009089 BCBS
Minnesota Other 609344 BCBS
Minnesota Other 101455 BCBS
Minnesota Other 23-00008 BCBS
Minnesota Other HP22113 BCBS

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