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Dermatology Center for Children & Young Adults PA

Pediatric Dermatology Physician in Eagan, MN · enumerated 2006 · authorized official Kenneth Bloom, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053417055

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Registry record

Entity type Organization (Type 2)
Legal business name Dermatology Center for Children & Young Adults PA
Practice address 2795 Pilot Knob Rd, Suite 300, Eagan, MN, 55121
Phone (651) 379-9999
Fax (651) 379-9900
Enumeration date Sep 16, 2006
Last updated in NPPES Apr 20, 2008

Taxonomy & classification

207NP0225X Pediatric Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Kenneth Bloom
Title President
Phone (651) 379-9999

Other identifiers

Identifier Type State Issuer
2M741DE Other - BLUE CROSS BLUE SHIELD
013837 Medicaid ND -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Dermatology Center for Children & Young Adults PA?
Dermatology Center for Children & Young Adults PA is registered in NPPES as a Pediatric Dermatology Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-04-20.