TWIN CITIES ORAL & MAXILLOFACIAL SURGERY PA


Address: 14635 Pennock Ave, #250, Apple Valley, MN 55124-6430
Phone: 9524321514

TWIN CITIES ORAL & MAXILLOFACIAL SURGERY PA (NPI# 1821299041) 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) 1821299041
Entity Type Organization
Organization Name TWIN CITIES ORAL & MAXILLOFACIAL SURGERY PA
Practice Address 14635 Pennock Ave
#250
Apple Valley
MN 55124-6430
Mailing Address 925 Highway 55
Ste 202
Hastings
MN 55033-3734
Practice Telephone 9524321514
Mailing Telephone 6514373262
Enumeration Date 2007-05-29
Last Update Date 2020-08-22
Authorized Official Name SHIRLEY HERDING (OFFICE MANAGER)
Authorized Official Telephone 9524321514
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QS0112X Clinic/Center
Specialization: Oral and Maxillofacial Surgery
Ambulatory Health Care Facilities

Office Location

Street Address 14635 PENNOCK AVE
#250
City APPLE VALLEY
State MN
Zip Code 55124-6430

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104865179 Ameli Chiropractic Clinic P.a. Chiropractor 14635 Pennock Ave, Suite 200, Apple Valley, MN 55124-6430 2006-06-05
1902344757 Alexandra Johnson Chiropractor 14635 Pennock Ave, 200, Apple Valley, MN 55124-6430 2017-02-01
1902239825 Katherine Sebastian Specialist 14635 Pennock Ave, Suite #300, Apple Valley, MN 55124-6430 2013-08-14
1306080890 Jaclyn Ashley Hillstrom Occupational Therapist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2009-04-28
1689869604 Traci Friede Occupational Therapist 14635 Pennock Ave, Suite #300, Apple Valley, MN 55124-6430 2007-09-12
1578607586 Rachel Tressel Physical Therapist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2007-02-16
1346384336 Christine Spray Occupational Therapist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2007-02-16
1982747127 Kerry Oliver Occupational Therapist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2007-02-15
1679616734 Deborah Ruskell Speech-Language Pathologist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2007-02-15
1952444101 Aimee Peterson Occupational Therapist 14635 Pennock Ave, Suite 300, Apple Valley, MN 55124-6430 2007-02-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518574672 Carol Susan Elstad Counselor Mn Mental Health Clinics, 15160 Foliage Ave Suite 140, Apple Valley, MN 55124 2020-09-23
1629612569 Gadaa Care Transportation Non-emergency Medical Transport (VAN) 7296 157th St W, Apple Valley, MN 55124 2019-11-04
1356831515 Dustin W Seabolt Hearing Instrument Specialist 15071 Dunwood Trl, Apple Valley, MN 55124 2018-05-14
1639687189 Dentalign P.a. Clinic/Center 15875 Emperor Avenue, Apple Valley, MN 55124 2018-01-18
1982126926 Apex Family Chiropractic LLC Chiropractor 15678 Pilot Knob Road, Suite 120, Apple Valley, MN 55124 2017-07-12
1821523028 Robin Marie Parker Nurse Practitioner 14135 Cedar Avenue South, Suite 100, Apple Valley, MN 55124 2017-04-25
1134578826 Ellen Denise Jacobson Dentist 14682 Pennock Avenue South, Apple Valley, MN 55124 2016-06-03
1831568708 Clearriver Inc. Home Health 13790 Elkhart Rd, Apple Valley, MN 55124 2015-09-21
1265826879 Next Level Fitness Co Public Health or Welfare 14645 Felton Ct, 104, Apple Valley, MN 55124 2015-03-20
1568872216 Jon Butala Marriage & Family Therapist 4300 W 147th St., Suite 204, Apple Valley, MN 55124 2014-05-04
Find all providers in zip 55124

Taxonomy Information

Taxonomy Code 261QS0112X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
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 state

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
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
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Competitor

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City APPLE VALLEY
Zip Code 55124

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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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