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

Southdale Physicians, LLC

Organization Dermatology Physician · NPI 1124569249

Southdale Physicians, LLC is a Dermatology Physician in Edina, Minnesota. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6565 France Ave S Ste 350
Edina, MN 55435-2137
Phone: (612) 430-8120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Dermatology Physician Taxonomy 207N00000X

Record details

NPI number1124569249
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derek Dagendesh — Office Administrator · (952) 999-4049
NPI enumeratedMarch 9, 2017
Last updated in NPPESFebruary 17, 2025
Certification dateFebruary 17, 2025
Mailing address6565 France Ave S Ste 350, Edina, MN 55435-2137

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