SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES (NPI# 1659492312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659492312 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES |
| Practice Address |
605 Hillcrest Ave Ste 130 Owatonna MN 55060-3680 |
| Practice Telephone | 5074510290 |
| Practice Fax Number | 5074510291 |
| Mailing Telephone | 5074510290 |
| Mailing Fax Number | 5074510291 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT A NUSTAD (VP, TREASURER) |
| Authorized Official Telephone | 5074510290 |
| Authorized Official Credential | DDS, MS |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Street Address |
605 HILLCREST AVE STE 130 |
| City | OWATONNA |
| State | MN |
| Zip Code | 55060-3680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013047026 | Karen Ann Swenson | Licensed Practical Nurse | 605 Hillcrest Ave Ste 130, Owatonna, MN 55060-3680 | 2007-03-07 |
| 1770798936 | Dominique Rae Stadler | Licensed Practical Nurse | 605 Hillcrest Ave Ste 130, Owatonna, MN 55060-3680 | 2007-05-11 |
| 1013047000 | Lianna Marie Doocy | Dental Assistant | 605 Hillcrest Ave Ste 130, Owatonna, MN 55060-3680 | 2007-03-07 |
| 1407986417 | Melody Kay Vanhoudt | Licensed Practical Nurse | 605 Hillcrest Ave Ste 130, Owatonna, MN 55060-3680 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936480 | Lee Joseph Bakewell | Nurse Practitioner | 2200 Nw 26th St, Owatonna, Owatonna, MN 55060 | 2019-01-25 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1801326418 | Katharyn Kristin Stricklin | Registered Nurse | 1961 Premier Drive, Suite 340 Mankato, Mankato, MN 55060 | 2017-06-15 |
| 1134666753 | Holly Christianson | Social Worker | 2575 Harvest Lane Nw, Owatonna, MN 55060 | 2017-01-20 |
| 1346613031 | Birchwood Cottages | Assisted Living Facility | 1905 Austin Road, Owatonna, MN 55060 | 2015-11-04 |
| 1881080067 | Cory Michael Kopas | Chiropractor | 130 26th Street Nw, Owatonna, MN 55060 | 2015-04-14 |
| 1528456613 | Quality Home Health Care Inc. | Home Health | 201 East Front Street, Owatonna, MN 55060 | 2014-12-26 |
| 1194017624 | Amy Louise Haycraft | Nurse Practitioner | South Central Human Relations Center, 610 Florence Ave, Owatonna, MN 55060 | 2011-05-02 |
| 1710123971 | Rahn Optometry Inc | Optometrist | 1130 W. Frontage Rd, Owatonna, MN 55060 | 2008-12-18 |
| 1063616993 | Michael John Dickman | Dentist | 1414 S Oak Ave Suite Five, Owatonna, MN 55060 | 2007-06-13 |
| Find all providers in zip 55060 | ||||
| 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 |
| 1356542575 | Twin Cities Oral & Maxillofacial Surgery, Pa | Clinic/Center | 1655 Beam Ave, Ste 208, Maplewood, MN 55109-1163 | 2007-05-29 |
| 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.