SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES (NPI# 1770776312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770776312 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES |
| Practice Address |
3632 10th Ln Nw Rochester MN 55901-7032 |
| Practice Telephone | 5072815000 |
| Practice Fax Number | 5072815001 |
| Mailing Telephone | 5072815000 |
| Mailing Fax Number | 5072815001 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | DR. ROBERT A NUSTAD (VP, TREASURER) |
| Authorized Official Telephone | 5072815000 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1659492312 | Southeastern Minnesota Oral & Maxillofacial Surgery Associates | Clinic/Center | 605 Hillcrest Ave Ste 130, Owatonna, MN 55060-3680 | 2007-04-02 |
| Street Address |
3632 10TH LN NW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55901-7032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649215328 | Joel C Michelson | Dentist | 3632 10th Ln Nw, Rochester, MN 55901-6917 | 2006-06-18 |
| 1669851192 | Caitlin Heggestad | Optometrist | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2015-05-29 |
| 1730498478 | Lisa A Rosenau | Dental Assistant | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2010-09-29 |
| 1376790543 | Andrew Quentin Madson | Dentist | 3632 10th Ln Nw, Rochester, MN 55901 | 2008-08-19 |
| 1316107790 | Lifetime Eye Care of Rochester Inc | Eyewear Supplier (Equipment, not the service) | 3632 10th Ln Nw, Suite 2, Rochester, MN 55901-7032 | 2008-06-10 |
| 1386867703 | Susan Marie Stellmaker | Nurse's Aide | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2007-04-11 |
| 1598988891 | Sheryl Ann Benike | Licensed Practical Nurse | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2007-04-11 |
| 1437372166 | Joan Ellen Ojanen | Dental Assistant | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2007-04-11 |
| 1659402758 | Pamela Jane Adamson | Licensed Practical Nurse | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2007-03-08 |
| 1114948734 | Courtney Ray Sivertson | Optometrist | 3632 10th Ln Nw, Rochester, MN 55901-7032 | 2006-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1497303150 | Tatenda Valentine Rudziva | Nurse Practitioner | 2989 315 Elton Hills Drive Nw, Suite 201, Rochester, MN 55901 | 2019-08-27 |
| 1629566872 | Juan Simon Rico Mesa | Student in an Organized Health Care Education/Training Program | 4502 Medical Drive, San Antonio, 78229, San Antonio, TX 55901 | 2018-04-24 |
| 1336658277 | Minnesota Teen Challenge | Exclusive Provider Organization | 1542 Assisi Drive Nw, Rochester, MN 55901 | 2017-09-22 |
| 1235648270 | Mariah Adanene | Registered Nurse | 915 41st Street Nw, Rochester, MN 55901 | 2017-09-21 |
| 1912420639 | Anna Maria Schuman | Speech-Language Pathologist | 2746 Superior Drive Nw, Suite Number 150, Rochester, MN 55901 | 2017-07-25 |
| 1871013870 | Rhonda Keith | Counselor | 602 11th Avenue Nw #300, Rochester, MN 55901 | 2017-06-21 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1659810844 | Rx Team Home Health Care LLC | Home Health | 1027 7th St Nw Unit #204, Rochester, MN 55901 | 2017-02-21 |
| 1457713109 | Joshua Carter | Chiropractor | 3270 19th St Nw Ste 203, Rochester, MN 55901 | 2016-03-22 |
| Find all providers in zip 55901 | ||||
| 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 |
|---|---|---|---|---|
| 1497317705 | Albert J Wesley D D S PC | Clinic/Center | 511 Olde Towne Road #81907, Rochester, MI 48308 | 2019-07-08 |
| 1043452923 | Dave C Pak Dmd Md Pa | Clinic/Center | 123 Washington St, Rochester, NH 03839-5505 | 2009-03-24 |
| 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 |
| 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 |
| 1154522373 | Twin Cities Oral & Maxillofaical Surgery Pa | Clinic/Center | 1790 Lexington Ave N, Roseville, MN 55113-6167 | 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.