DBA: ORIGINS EYE CLINIC
NPI 1730472523
Optometrist in St Louis Park, MN

Q: What is Cedar Lakes Eye Specialists PA's NPI number?

The NPI number for Cedar Lakes Eye Specialists PA is 1730472523. It was assigned to this organization in the NPPES registry on May 26, 2011. The provider is doing business as Dba: Origins Eye Clinic.

Q: What is Cedar Lakes Eye Specialists PA's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since May 26, 2011

5801 W 16TH ST, ST LOUIS PARK, MN 55416(763) 582-9601(763) 582-9613 Get Directions Write a Review

NPPES record last updated: April 30, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dba: Origins Eye Clinic NPPES

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

DBA: ORIGINS EYE CLINIC (NPI 1730472523) is a healthcare organization registered as an optometrist in St Louis Park, Minnesota and active in the NPI registry since May 2011. The organization lists David Bane, Owner, as its authorized official.

NPPES Registry Identity

NPI1730472523

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameCEDAR LAKES EYE SPECIALISTS PA

Location Address5801 W 16TH STSt Louis Park, MN 55416-1446

Mailing AddressPo Box 1170Maple Grove, MN 55311-6170 · (763) 582-9601 · Fax (763) 582-9613

Phone(763) 582-9601

Fax(763) 582-9613

Organization SubpartNo

Authorized OfficialDavid BaneOwner · (763) 582-9601

Enumeration DateMay 26, 2011

Last NPPES UpdateApril 30, 2018

✔ NPI 1730472523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in MN · 3009

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

5801 W 16TH ST, St Louis Park, MN 55416

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Other Names 1

Doing Business AsDba: Origins Eye Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

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

JOSEPH VARGO

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)