Healthcare Provider Details

I. General information

NPI: 1568396489
Provider Name (Legal Business Name): ELIZABETH EDNA ISAACSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 DELAWARE ST SE
MINNEAPOLIS MN
55455-0357
US

IV. Provider business mailing address

5375 EUREKA RD
SHOREWOOD MN
55331-7963
US

V. Phone/Fax

Practice location:
  • Phone: 952-353-0177
  • Fax:
Mailing address:
  • Phone: 952-353-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD15473
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: