MEDICARE: JESSICA DANG PA

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	363AS0400X	Surgical Physician Assistant		MN

General Provider Information

NPI Number	:	1811855588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DANG PA

Provider Business Mailing Address
First Line	:	6371 HARTFORD CIR
Second Line	:
City	:	LINO LAKES
State	:	MN
Zip	:	55038-7771
Country	:	US
Telephone Number	:	651-900-1839
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E 28TH ST STE H2100
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-3723
Country	:	US
Telephone Number	:	612-863-3900
Fax Number	:	612-863-3784

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ JESSICA DANG PA” Practice Location

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