SOUTHDALE PHYSICIANS, LLC – NPI #1124569249
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Health Care Provider Taxonomy Code for Internal Medicine

SOUTHDALE PHYSICIANS, LLC is a provider located in EDINA, MN. NPPES has assigned the NPI number 1124569249 to SOUTHDALE PHYSICIANS, LLC on March 09, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was last updated on Feb 17, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHDALE PHYSICIANS, LLC below.

NPI Profile for
SOUTHDALE PHYSICIANS, LLC

NPI Number
1124569249
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHDALE PHYSICIANS, LLC
Primary location
6565 FRANCE AVE S STE 350
EDINA, MN 55435-2137
Phone: (612) 430-8120 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DEREK DAGENDESH
OFFICE ADMINISTRATOR
Phone: (952) 999-4049
Updated
Certification Date
Feb 17, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
207N00000X
- Dermatology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.