Provider Demographics
NPI:1538056965
Name:PADILLA, EMILY YAJAIRA (DDS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:YAJAIRA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 RAYMOND AVE APT 337
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1736
Mailing Address - Country:US
Mailing Address - Phone:651-403-1148
Mailing Address - Fax:
Practice Address - Street 1:1970 BUERKLE RD
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-1300
Practice Address - Country:US
Practice Address - Phone:651-477-8169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist