SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES (NPI# 1902099559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902099559 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN MINNESOTA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES |
| Practice Address |
2835 S Service Dr Red Wing MN 55066-1882 |
| Practice Telephone | 6513881515 |
| Practice Fax Number | 6513885912 |
| Mailing Telephone | 6513881515 |
| Mailing Fax Number | 6513885912 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | DR. ROBERT A NUSTAD (VP, TREASURER) |
| Authorized Official Telephone | 6513881515 |
| 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 |
| 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 |
2835 S SERVICE DR |
| City | RED WING |
| State | MN |
| Zip Code | 55066-1882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861525214 | Jodi Lynn Halling | Licensed Practical Nurse | 2835 S Service Dr, Red Wing, MN 55066-1882 | 2007-03-14 |
| 1982074845 | Kathleen Marie Howard | Counselor | 2835 S Service Dr, Suite 103, Red Wing, MN 55066-1882 | 2015-10-04 |
| 1912387184 | Comprehensive Behavioral Health Services | Clinic/Center | 2835 S Service Dr, Suite 203, Red Wing, MN 55066-1882 | 2015-06-03 |
| 1962701375 | Lynda Anne Szymanski | Psychologist | 2835 S Service Dr, Suite 203, Red Wing, MN 55066-1882 | 2011-03-24 |
| 1629102520 | Alethea J Drahos | Specialist/Technologist, Other | 2835 S Service Dr, Red Wing, MN 55066-1882 | 2007-03-15 |
| 1982737318 | Susan Ann Nelson | Licensed Practical Nurse | 2835 S Service Dr, Red Wing, MN 55066-1882 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750850376 | Midwest Transit | Transportation Broker | 217 Plum Street, Suite #220, Red Wing, MN 55066 | 2018-11-14 |
| 1407343221 | Ethos Physical Therapy LLC | Physical Therapist | 2030 Neal St, Redwing, MN 55066 | 2018-04-17 |
| 1255759205 | Brittney Joy Amdahl | Acupuncturist | 201 East Ave., Suite D, Red Wing, MN 55066 | 2014-04-06 |
| 1689807000 | Sarah Jean Haar | Massage Therapist | 416 W. 3rd St., Red Wing, MN 55066 | 2009-09-02 |
| 1437395241 | George Edward Jackish | Internal Medicine | 28089 Bayview Drive, Red Wing, MN 55066 | 2008-12-29 |
| 1750554754 | Jess Brehmer | Orthopaedic Surgery | 701 Hewitt Bvld, Red Wing, MN 55066 | 2008-04-10 |
| 1992825517 | Joseph H. Sevlie | Chiropractor | 1626 W. 3rd St., Red Wing, MN 55066 | 2007-03-29 |
| 1134269392 | City of Red Wing | Ambulance | 315 W 4th St, Red Wing, MN 55066 | 2007-02-07 |
| 1225196512 | Kathryn Zoff Seivert Phd Lp Pa | Psychologist | 1751 Reichert Ave, Red Wing, MN 55066 | 2006-12-05 |
| 1417024217 | Kevin Curtis Smith | Chiropractor | 212 Fulton, Red Wing, MN 55066 | 2006-11-29 |
| Find all providers in zip 55066 | ||||
| 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 |
| 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.