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General NPI Number Information
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NPI Number | 1265943526
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Entity Type | Individual
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Provider Name | POOJA PALAKSHA
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Gender | Female
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3434 LEXINGTON AVE N STE 700
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City | SHOREVIEW
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State | MN
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Zip | 55126-8086
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Country | US
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Telephone | 651-483-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 11781 HARVEST PATH
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City | WOODBURY
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State | MN
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Zip | 55129-7808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D15385
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License Number State | MN
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