LAKE AREA DERMATOLOGY PA – Dermatology Physician, NPI 1710270921

LAKE AREA DERMATOLOGY PA is a healthcare provider. based in Eagan, Minnesota. specializing in Dermatology Physician. The NPI Number for LAKE AREA DERMATOLOGY PA is 1710270921

Main info

Organization
Name
LAKE AREA DERMATOLOGY PA
NPI
1710270921
Phone
(651) 224-4930
Address
2854 HIGHWAY 55
Authorized Official
TRACY FUCHS GANNON PRESIDENT / OWNER M.D.
Enumeration Date
20 May 2011
Last Update Date
3 June 2011
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:15State licenses:0Digital endpointsOther names

Provider Addresses for LAKE AREA DERMATOLOGY PA

  • 2854 HIGHWAY 55

    SUITE 130

    EAGAN, MN 551211447

    Phone: (651) 224-4930

    Fax: (651) 842-3391

    Type: Mailing

  • 3640 TALMAGE CIR

    SUITE 216

    VADNAIS HEIGHTS, MN 551104183

    Phone: (651) 224-4930

    Fax: (651) 842-3391

    Type: Location

NPPES updates history

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Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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Insurance plans in this area (ZIP 55121)

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Frequently asked questions

What NPI should I save for LAKE AREA DERMATOLOGY PA?
Save NPI 1710270921 if you need a stable reference for LAKE AREA DERMATOLOGY PA.
Does this profile mean LAKE AREA DERMATOLOGY PA is currently active?
Yes — LAKE AREA DERMATOLOGY PA appears active in the national provider directory.
What field does LAKE AREA DERMATOLOGY PA work in?
You can think of LAKE AREA DERMATOLOGY PA as practicing within Dermatology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for LAKE AREA DERMATOLOGY PA?
The page summarizes Eagan, Minnesota for LAKE AREA DERMATOLOGY PA; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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