Northside Minnesota Oral and Maxillofacial Surgeons, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC

Practice address

11441 Osage St NW
Coon Rapids, MN 55433-3677

Phone

(763) 862-6442

NPI assigned

Jun 22, 2021

Last updated

Jun 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohamed El DeebNPI 1578552311

Title

Owner

Phone

(763) 862-6442

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamed E El Deeb, DDS DOS MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Coon Rapids, MN
  • NPI 1578552311
  Authorized official Same address or phone

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1245809458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11441 OSAGE ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11441 OSAGE ST NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333677",
            "telephone_number": "763-862-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "EL DEEB",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-862-6442"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northland Dental Partners, PLLC (Cedar Bend Dental Care)
• Northland Hearing Centers, Inc. (Sound Point Audiology)
• Northside Minnesota Oral and Maxillofacial Surgeons
• Northstar Sleep Center LLC
• Northtown Psychology Associates LLC
• Northwest Passage High School
• Northwind Lung Specialists, P.a. (Northwind Lung Specialists & Sleep Center)
• Kelsey Nosek, DO

• Oral and Maxillofacial Surgery Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.