DR. KIM M LEDERMANN D.D.S.
NPI 1205991726
Dentist in Saint Paul, MN

Q: What is Kim Ledermann's NPI number?

The NPI number for Kim Ledermann is 1205991726. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Q: What is Kim Ledermann's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Kim Ledermann enrolled in Medicare?

No. Kim Ledermann has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kim Ledermann was last updated on November 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 26, 2006Opted out of Medicare · through Oct 1, 2027

2550 UNIVERSITY AVE W, SUITE143N, SAINT PAUL, MN 55114(651) 642-1013(651) 642-0947 Get Directions Write a Review

NPPES record last updated: November 13, 2014. Verified against the NPPES registry weekly; last sync: September 20, 2026.

On this page

About Dr. Kim M Ledermann D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KIM M LEDERMANN D.D.S. (NPI 1205991726) is an individual dentist in Saint Paul, Minnesota, licensed in Minnesota (D11715) and active in the NPI registry since December 2006. She has opted out of Medicare through October 1, 2027 and remains eligible to order and refer and is a graduate of University Of Minnesota School Of Dentistry (2002).

NPPES Registry Identity

NPI1205991726

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. KIM M LEDERMANNCredential: D.D.S.

Location Address2550 UNIVERSITY AVE W, SUITE143NSaint Paul, MN 55114-1052

Mailing Address5030 Emerson Ave SMinneapolis, MN 55419-1154 · (612) 823-1824 · Fax (651) 642-0947

Phone(651) 642-1013

Fax(651) 642-0947

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota School Of DentistryGraduated 2002

Enumeration DateDecember 26, 2006

Last NPPES UpdateNovember 13, 2014

✔ NPI 1205991726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · D11715

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2550 UNIVERSITY AVE W, Saint Paul, MN 55114

Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified321818000MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kim M Ledermann D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2019 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2019

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MELISSA LEA URBANEK LMFT

Marriage & Family Therapist

2550 UNIVERSITY AVE W, STE 435 S
SAINT PAUL, MN 55114

Ramsey County (651) 647-1900

MICHELLE S KENNEDY MD

Internal Medicine (Gastroenterology)

2550 UNIVERSITY AVE W, SUITE 423 SOUTH
SAINT PAUL, MN 55114

Ramsey County (612) 870-5557

TYANN ZEAL R.D., L.D.

Dietitian, Registered

2550 UNIVERSITY AVE W
SAINT PAUL, MN 55114

Ramsey County (952) 993-6200

AMY LAWRENCE L.M.F.T.

Marriage & Family Therapist

2550 UNIVERSITY AVE W, SUITE 314N
SAINT PAUL, MN 55114

Ramsey County (651) 645-5323

SHANNON O'DONNELL L.P.

Psychologist (Clinical)

2550 UNIVERSITY AVE W, SUITE 314N
SAINT PAUL, MN 55114

Ramsey County (651) 645-5323

EMILY KATHRYN KAHNERT DPT

Physical Therapist

2550 UNIVERSITY AVE W, SUITE 189S
SAINT PAUL, MN 55114

Ramsey County (651) 332-7474

GERALD PATRICK CRIMMINS PSYD CP

Psychologist

2550 UNIVERSITY AVE W, STE 229N
SAINT PAUL, MN 55114

Ramsey County (651) 645-3115

CARMEN JEAN JACOBSON P.A.-C

Physician Assistant (Medical)

2550 UNIVERSITY AVE W, SUITE 110N
SAINT PAUL, MN 55114

Ramsey County (651) 602-5311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Ledermann's NPI number?

The NPI number for Kim Ledermann is 1205991726. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Where is Kim Ledermann located?

Kim Ledermann practices at 2550 University Ave W Suite143n, Saint Paul, MN 55114. The listed phone number is (651) 642-1013.

What is Kim Ledermann's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kim Ledermann enrolled in Medicare?

No. Kim Ledermann has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kim Ledermann was last updated on November 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.