Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southdale Periodontics, PLLC

Organization Periodontics · NPI 1134547730

Southdale Periodontics, PLLC provides Periodontics in Edina, Minnesota. Licensed in Minnesota. Registered with an NPI since 2014.

Licensed in
MN
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6545 France Ave S Ste 190
Edina, MN 55435-2131 Not confirmed with CMS for 12 years — call before visiting
Phone: (952) 922-6949
Fax: (952) 922-9287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence D12016 (MN)

Record details

NPI number1134547730
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Russell Dylla — Owner · (952) 922-6949
NPI enumeratedApril 1, 2014
Last updated in NPPESApril 1, 2014
Mailing address6545 France Ave S, Suite 190, Edina, MN 55435-2131

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