MEDICARE: MISS ALEXIS LIPPE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	D14693	MN

General Provider Information

NPI Number	:	1528566593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALEXIS LIPPE DDS

Provider Business Mailing Address
First Line	:	700 VILLAGE CENTER DR STE 100
Second Line	:
City	:	NORTH OAKS
State	:	MN
Zip	:	55127-3020
Country	:	US
Telephone Number	:	651-483-5134
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 VILLAGE CENTER DR STE 100
Second Line	:
City	:	NORTH OAKS
State	:	MN
Zip	:	55127-3020
Country	:	US
Telephone Number	:	651-483-5134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	03/26/2025

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