Edina Oral and Maxillofacial Surgery, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D11128 Issued in MN

Legal business name

EDINA ORAL AND MAXILLOFACIAL SURGERY, P.A.

Practice address

6545 France Ave S
Suite 690
Edina, MN 55435-2131

Phone

(952) 925-2525

Fax

(952) 925-2529

NPI assigned

May 11, 2012

Last updated

May 11, 2012By 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

Paul C Tompach

Title

Owner/Doctor

Phone

(952) 925-2525

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1275892218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "address_2": "SUITE 690",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-925-2525",
            "fax_number": "952-925-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "address_2": "SUITE 690",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-925-2525",
            "fax_number": "952-925-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDINA ORAL AND MAXILLOFACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "TOMPACH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "952-925-2525"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D11128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edina Medical Supplies, Inc.
• Edina MN Ophthalmology ASC LLC (McCannel Eye Surgery)
• Edina MN Ophthalmology ASC LLC (McCannel Eye Surgery)
• Edina Modern Dentistry, PC
• Edina Nursing and Rehab, LLC
• Edina Plastic Surgery, LTD.
• Edina Psychology, S.C.
• Edina Retina Consultants
• Edina Senior Living LLC (Aurora on France)
• Edina Senior Living, LLC (Aurora on France)

• Oral and Maxillofacial Surgery (Dentist) in Edina, MN
• Providers in Edina, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.