Healthcare Provider Details

I. General information

NPI: 1376336511
Provider Name (Legal Business Name): JOSHUA JAMES PFISTER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHASKA CREEK WAY STE 110
CHASKA MN
55318-2749
US

IV. Provider business mailing address

1200 CHASKA CREEK WAY STE 110
CHASKA MN
55318-2749
US

V. Phone/Fax

Practice location:
  • Phone: 952-466-3937
  • Fax:
Mailing address:
  • Phone: 320-587-6308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4001
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: