MINNESOTA ORAL AND FACIAL SURGERY PLLC


Address: 2380 Troop Dr Unit 202, Sartell, MN 56377-4637
Phone: 3202579555

MINNESOTA ORAL AND FACIAL SURGERY PLLC (NPI# 1194363275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194363275
Entity Type Organization
Organization Name MINNESOTA ORAL AND FACIAL SURGERY PLLC
Practice Address 2380 Troop Dr Unit 202
Sartell
MN 56377-4637
Practice Telephone 3202579555
Practice Fax Number 3202579558
Mailing Telephone 3202579555
Mailing Fax Number 3202579558
Enumeration Date 2019-12-19
Last Update Date 2019-12-19
Authorized Official Name DEEPAK KADEMANI (OWNER)
Authorized Official Telephone 6125680570
Authorized Official Credential DMD, MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 204E00000X Oral & Maxillofacial Surgery Allopathic & Osteopathic Physicians
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
Dental Providers

Office Location

Street Address 2380 TROOP DR UNIT 202
City SARTELL
State MN
Zip Code 56377-4637

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659787380 Julie Kline Nurse Practitioner 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 2014-07-02
1982242061 Minnesota Head and Neck Surgery Pllc Oral & Maxillofacial Surgery 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 2019-12-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235783515 Chae Norman Massage Therapist 303 4th Ave S, Suite C, Sartell, MN 56377 2019-07-25
1497317259 Stephanie Maria Schaefer Behavioral Analyst 1133 Mockingbird Loop, Sartell, MN 56377 2019-07-02
1538722848 Madison Toughill Behavior Technician 205 14th Ave E, Sartell, MN 56377 2019-04-22
1902388671 Julie Ann Helms Counselor 101 Dehler Dr., Sartell, MN 56377 2018-08-30
1104337617 Louis Chester Winskowski IIi Orthotist 50 14th Ave E Suite 114, Sartell, MN 56377 2017-10-24
1962958611 Centracare Clinic Exclusive Provider Organization 166 19th Street S, Suite 202, Sartell, MN 56377 2016-08-31
1295197846 Mindful Healing & Training Counselor 1417 15th Street South, Sartell, MN 56377 2016-03-23
1710342894 Saint Cloud Hospital St. Benedict's Senior Community Skilled Nursing Facility 990 19th St. S., Sartell, MN 56377 2015-12-16
1932452661 David Peter Pogatchnik Pharmacist 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 2012-10-18
1669759866 Lakewood Health System Clinic/Center 161 19th St S Ste 106, Sartell, MN 56377 2011-11-16
Find all providers in zip 56377

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699964320 Roderick Duane Vansurksum Dentist 2380 Troop Dr, Ste 202, Sartell, MN 56377-4636 2007-10-18
1386723575 Central Lakes Oral & Facial Surgery Dentist 2380 Troop Drive, Ste 202, Sartell, MN 56377 2006-11-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982213237 Yue Hu Dentist 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 2020-07-23
1285294611 Brian Michael Laing Dentist 7-147 Moos Health Science Tower, 515 Delaware Street S.e., Minneapolis, MN 55455-0357 2019-06-18
1295218303 Advanced Oral Surgery Dentist 19925 Idealic Ave, Lakeville, MN 55044-2003 2018-09-13
1205366002 Derek Miller Dentist 7-174 Moos Tower 515 Delaware St. S, U of M Oral Surgery, Minneapolis, MN 55455 2017-06-14
1497113674 West Lakes Dentistry, Pa Dentist 5205 Shoreline Dr, Mound, MN 55364-1770 2016-02-03
1003203498 Tyler John Varhol Dentist 550 County Road D W Ste 12, New Brighton, MN 55112-3517 2015-04-23
1225458391 Levi Zarbano Dentist 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 2014-04-16
1154760932 John Salek-raham Dentist 700 Village Center Dr., Ste 170, North Oaks, MN 55127-3025 2013-06-14
1649511585 Kristopher Lee Hasstedt Dentist Dentists of Woodbury, 7150 Valley Creek Plaza Ste #230, Woodbury, MN 55125 2013-03-01
1396095048 Dental Specialists of Minnesota, Pllc Dentist 3360 Northdale Blvd., Coon Rapids, MN 55448-1825 2012-09-10
Find all providers with the same taxonomy

Competitor

Search similar providers

City SARTELL
Zip Code 56377

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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