TWIN CITIES ORAL & MAXILLOFACIAL SURGERY, PA (NPI# 1356542575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356542575 |
| Entity Type | Organization |
| Organization Name | TWIN CITIES ORAL & MAXILLOFACIAL SURGERY, PA |
| Practice Address |
1655 Beam Ave Ste 208 Maplewood MN 55109-1163 |
| Mailing Address |
925 Highway 55 Ste 202 Hastings MN 55033-3734 |
| Practice Telephone | 6517707703 |
| Mailing Telephone | 6514373262 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHIRLEY HERDING (OFFICE MANAGER) |
| Authorized Official Telephone | 6514373262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
1655 BEAM AVE STE 208 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942297171 | Robert Adams Gaertner | Urology | 1655 Beam Ave, Suite 206, Maplewood, MN 55109-1163 | 2005-10-03 |
| 1679028617 | Alicia Luftman | Dietitian, Registered | 1655 Beam Ave, Suite 302, Maplewood, MN 55109-1163 | 2016-08-19 |
| 1740668102 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 1655 Beam Ave, Suite 308, Maplewood, MN 55109-1163 | 2015-05-18 |
| 1770900797 | Allergy and Asthma Center of Minnesota Pllc | Allergy & Immunology | 1655 Beam Ave, Suite 108, Maplewood, MN 55109-1163 | 2014-03-27 |
| 1871858639 | Ashley Marie Zilles | Surgery | 1655 Beam Ave, Maplewood, MN 55109-1163 | 2012-07-09 |
| 1700163474 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 1655 Beam Ave, Ste. 308, Maplewood, MN 55109-1163 | 2011-11-09 |
| 1114200508 | Ryan P Tully | Physical Therapist | 1655 Beam Ave, Maplewood, MN 55109-1163 | 2011-09-22 |
| 1477854404 | Kaitlin Ileen Thompson | Dietitian, Registered | 1655 Beam Ave, #330, Maplewood, MN 55109-1163 | 2010-11-08 |
| 1730416959 | Lindsey Kay Syverson | Dietitian, Registered | 1655 Beam Ave, #302, Maplewood, MN 55109-1163 | 2009-11-09 |
| 1295977395 | Pediatric and Young Adult Medicine, Pa | Clinic/Center | 1655 Beam Ave, Suite 108, Maplewood, MN 55109-1163 | 2009-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164763629 | Regents of The University of Minnesota | Clinic/Center | 515 Delaware St Se, 7th Floor Moos Tower, Minneapolis, MN 55455-0357 | 2013-03-08 |
| 1699901140 | Northern Star Oral and Maxillofacial Surgery Pllc | Clinic/Center | 5100 Gamble Dr, Suite 125, St Louis Park, MN 55416-1585 | 2009-06-10 |
| 1447429402 | Regents of The University of Minnesota | Clinic/Center | 515 Delaware St Se, 7th Floor Moos Tower, Minneapolis, MN 55455-0357 | 2008-02-25 |
| 1427237551 | Midtling Oral & Maxillofacial Surgery, Pa | Clinic/Center | 155 Wabasha St S, Suite 111, Saint Paul, MN 55107-1801 | 2007-10-25 |
| 1770776312 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2007-08-27 |
| 1902099559 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 2835 S Service Dr, Red Wing, MN 55066-1882 | 2007-08-27 |
| 1104019744 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 605 W Oakland Ave, Austin, MN 55912-2317 | 2007-08-27 |
| 1144413782 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 304 Belle Ave, Mankato, MN 56001-5250 | 2007-08-27 |
| 1821299041 | Twin Cities Oral & Maxillofacial Surgery Pa | Clinic/Center | 14635 Pennock Ave, #250, Apple Valley, MN 55124-6430 | 2007-05-29 |
| 1154522373 | Twin Cities Oral & Maxillofaical Surgery Pa | Clinic/Center | 1790 Lexington Ave N, Roseville, MN 55113-6167 | 2007-05-29 |
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| 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.