Provider Demographics
NPI:1437134541
Name:ANDREOTTI, DINA M (MD)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:M
Last Name:ANDREOTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:M
Other - Last Name:ANDREOTTI-RICKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1055 CENTERVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-5033
Mailing Address - Country:US
Mailing Address - Phone:651-326-5900
Mailing Address - Fax:651-426-8935
Practice Address - Street 1:1055 CENTERVILLE CIR
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-5033
Practice Address - Country:US
Practice Address - Phone:651-326-5900
Practice Address - Fax:651-426-8935
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE67670207Q00000X
NE21353207Q00000X
MN50370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine