Oral and Maxillofacial Surgical Associates PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES PA

Practice address

3712 Tower Ave
Suite E
Superior, WI 54880-5567

Phone

(715) 392-9846

Fax

(715) 392-7040

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Katherine Anne Lafleur, MBA

Title

Practice Administrator

Phone

(218) 722-1854

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Blue Water Oral and Facial Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Richard Seidelmann, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, MN
  • NPI 1922193770
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1003900994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 TOWER AVE",
            "address_2": "SUITE E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805567",
            "telephone_number": "715-392-9846",
            "fax_number": "715-392-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 TOWER AVE",
            "address_2": "SUITE E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805567",
            "telephone_number": "715-392-9846",
            "fax_number": "715-392-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "LAFLEUR",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "218-722-1854",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CLINIC",
            "identifier": "000078627",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987507700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Water Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brynn Olson, CFY-SLP
• Karen Olson
• Neil Olson
• Dustin Oosten, MS
• Op Orthodontics of Minnesota PLLC
• Catherine Orlandi
• Susan Kay Ostern, COTA
• Zachary T Otto, PHARMD
• Susan M Paine, RPH
• Katherine Marie Panula, LPC

• Oral and Maxillofacial Surgery (Dentist) in Superior, WI
• Providers in Superior, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.