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Lake Area Dermatology PA

Dermatology Physician in Vadnais Heights, MN · enumerated 2011 · authorized official Tracy Gannon, President / Owner.

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

National Provider Identifier

1710270921

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Registry record

Entity type Organization (Type 2)
Legal business name Lake Area Dermatology PA
Practice address 3640 Talmage Cir, Suite 216, Vadnais Heights, MN, 55110
Phone (651) 224-4930
Fax (651) 842-3391
Enumeration date May 20, 2011
Last updated in NPPES Jun 3, 2011

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Tracy Gannon
Title President / Owner
Phone (651) 224-4930

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

Who is the authorized official for Lake Area Dermatology PA?
NPPES lists Tracy Gannon (President / Owner) as the authorized official for this organization.
What is the NPI number for Lake Area Dermatology PA?
The NPI for Lake Area Dermatology PA is 1710270921, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-06-03.