Lake Area Dermatology PA
NPI 1710270921 · Dermatology Physician · Vadnais Heights, MN
Lake Area Dermatology PA is a Dermatology Physician organization in Vadnais Heights, MN (NPI 1710270921).
Provider details
- NPI number
- 1710270921
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tracy Gannon, President / Owner(651) 224-4930
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-05-20
- Last updated
- 2011-06-03
Frequently asked questions
- What is Lake Area Dermatology PA's NPI number?
- Lake Area Dermatology PA's National Provider Identifier (NPI) is 1710270921, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Area Dermatology PA?
- Lake Area Dermatology PA is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lake Area Dermatology PA located?
- Lake Area Dermatology PA's practice location on file with NPPES is 3640 Talmage Cir, Vadnais Heights, MN 55110-4183.
- What is Lake Area Dermatology PA's phone number?
- The practice phone number listed in the NPPES registry for Lake Area Dermatology PA is (651) 224-4930.
- Who is the authorized official for Lake Area Dermatology PA?
- The authorized official listed on Lake Area Dermatology PA's NPPES record is Tracy Gannon, President / Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Area Dermatology PA's NPI active?
- Yes — Lake Area Dermatology PA's NPI (1710270921) is active in the NPPES registry as of the last update on 2011-06-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.