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NPI Code Detail

MEDICARE: LISA HINDERAKER RDH

MEDICARE: LISA HINDERAKER RDH
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
1124Q00000XDental HygienistH10256MN

General Provider Information

NPI Number : 1720947211
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA HINDERAKER RDH
Provider Business Mailing Address
First Line : 1615 14TH ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0257
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1615 14TH ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0257
Country : US
Telephone Number : 507-529-0436
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “ LISA HINDERAKER RDH” Practice Location

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