ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A. (NPI# 1578596177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578596177 |
| Entity Type | Organization |
| Organization Name | ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A. |
| Practice Address |
1990 Premiere Dr Mankato MN 56001-5900 |
| Practice Telephone | 5076259330 |
| Practice Fax Number | 5076251440 |
| Mailing Telephone | 5076259330 |
| Mailing Fax Number | 5076251440 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. KIMBERLY JO URBAN (PRACTICE MANAGER) |
| Authorized Official Telephone | 5076259330 |
| Authorized Official Credential | R.D.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS # | 06D38MA | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275859159 | Associates In Oral and Maxillofacial Surgery, P.a. | Dentist | 2717 Superior Dr Nw, Suite B, Rochester, MN 55901-3035 | 2010-04-16 |
| 1285888024 | Associates In Oral and Maxillofacial Surgery, P.a. | Dentist | 2717 Superior Dr Nw, Suite B, Rochester, MN 55901-3035 | 2008-11-06 |
| Street Address |
1990 PREMIERE DR |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306908702 | Richard Kevin Marlow | Dentist | 1990 Premiere Dr, Mankato, MN 56001-5900 | 2006-12-14 |
| 1003977653 | Richard Hyungsang Kim | Dentist | 1990 Premiere Dr, Mankato, MN 56001-5900 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
|---|---|---|---|---|
| 1023307113 | Jonathan Colin Mccabe | Dentist | 116 Chaucer Ct, Mankato, MN 56001-5600 | 2011-03-30 |
| 1306908702 | Richard Kevin Marlow | Dentist | 1990 Premiere Dr, Mankato, MN 56001-5900 | 2006-12-14 |
| 1003977653 | Richard Hyungsang Kim | Dentist | 1990 Premiere Dr, Mankato, MN 56001-5900 | 2006-12-13 |
| 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 | ||||
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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.