Organization Active NPI

Associates in Oral and Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester, MN
National Provider Identifier
1275859159
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A.
Practice address
2717 Superior Dr NW
Suite B
Rochester, MN 55901-3035
Phone
(507) 281-5820
Fax
(507) 282-6543
NPI assigned
Apr 16, 2010
Last updated
Apr 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Authorized official

Name
Mrs. Margy Vickers
Title
Manager
Phone
(504) 281-5820

Specialties & licenses 1

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

Addresses

Primary practice location

2717 Superior Dr NW
Suite B
Rochester, MN 55901-3035

Mailing address

2717 Superior Dr NW
Suite B
Rochester, MN 55901-3035
Phone (507) 281-5820

Other identifiers 2

IdentifierTypeStateIssuer
06D38MAOtherMNBLUE CROSS BLUE SHIELD
857932600MedicaidMN

National Provider Directory

National Provider Directory
Tax ID family
Associates in Oral and Maxillofacial Surgery PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1275859159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 SUPERIOR DR NW",
            "address_2": "SUITE B",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013035",
            "telephone_number": "507-281-5820",
            "fax_number": "507-282-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 SUPERIOR DR NW",
            "address_2": "SUITE B",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013035",
            "telephone_number": "507-281-5820",
            "fax_number": "507-282-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN ORAL AND MAXILLOFACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "VICKERS",
        "authorized_official_first_name": "MARGY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-281-5820",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06D38MA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "857932600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.