Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Area Dermatology PA

Organization Dermatology Physician · NPI 1710270921

Lake Area Dermatology PA is a Dermatology Physician in Vadnais Heights, Minnesota. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110-4183
Phone: (651) 224-4930
Fax: (651) 842-3391
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1710270921
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tracy Gannon — President / Owner · (651) 224-4930
NPI enumeratedMay 20, 2011
Last updated in NPPESJune 3, 2011
Mailing address2854 Highway 55, Suite 130, Eagan, MN 55121-1447

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