Individual provider Active NPI

Duncan R Puffer, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, MN
National Provider Identifier
1073663449
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D10480 Issued in MN
Practice address
3617 W Arrowhead Rd
Duluth, MN 55811-4046
Phone
(218) 722-8377
Fax
(218) 722-3117
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D10480 MN Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4587 WI

Addresses

Primary practice location

3617 W Arrowhead Rd
Duluth, MN 55811-4046

Mailing address

3617 W Arrowhead Rd
Duluth, MN 55811-4046
Phone (218) 722-8377

Other identifiers 3

IdentifierTypeStateIssuer
33720200OtherWIWISCONSIN MEDICAID
6B745PUOtherMNMINNESOTA BCBS
143022000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100316001045 MN Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6002824463 Reassigns benefits to 1 organization
I20151001000066 WI Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 6002824463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
University of Minnesota School of Dentistry, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Northern Oral and Maxillofacial Surgeons PAGroup PAC ID 3072535863, 7 clinicians

Practice addresses (Care Compare)

3617 W Arrowhead Rd
Duluth, MN 55811-4046

3617 W Arrowhead Rd
Duluth, MN 55811-4132
Phone (218) 722-8377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4587WIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Oral & Maxillofacial Surgeons, PA Oral and Maxillofacial Surgery Current Accepting new patients
Northern Oral & Maxillofacial Surgeons, PA Oral and Maxillofacial Surgery CurrentSince Sep 1, 1993 Accepting new patients
Northern Oral & Maxillofacial Surgeons, PA Oral and Maxillofacial Surgery CurrentSince Sep 1, 1993 Accepting new patients

Locations

324 W Superior St
Duluth, MN 55802
Phone (218) 606-1797

3617 W Arrowhead Rd
Duluth, MN 55811
Phone (218) 722-4484

3899 Highway 73
Ste 6
Hibbing, MN 55746
Phone (218) 293-0691

1419 Beaser Ave
Ashland, WI 54806
Phone (715) 682-2660

503 Belknap St
Superior, WI 54880
Phone (715) 564-4081

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1073663449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114046",
            "telephone_number": "218-722-8377",
            "fax_number": "218-722-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W ARROWHEAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114046",
            "telephone_number": "218-722-8377",
            "fax_number": "218-722-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUFFER",
        "first_name": "DUNCAN",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D10480",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "4587",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN MEDICAID",
            "identifier": "33720200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BCBS",
            "identifier": "6B745PU",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143022000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.