NPIMap

Organization Active NPI

True North Oral Surgery and Implants PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodbury, MN
National Provider Identifier
1285179945
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D9734 Issued in MN
Legal business name
TRUE NORTH ORAL SURGERY AND IMPLANTS PLLC
Practice address
9950 Valley Creek Rd
Suite 100
Woodbury, MN 55125-4883
Phone
(651) 578-7000
Fax
(651) 578-0157
NPI assigned
Jan 4, 2017
Last updated
Apr 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Dr. Marshall Lloyd Wade, D.D.S.NPI 1386606937
Title
Oral Surgeon/President
Phone
(651) 578-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D9734 MN Primary

Addresses

Primary practice location

9950 Valley Creek Rd
Suite 100
Woodbury, MN 55125-4883

Mailing address

9950 Valley Creek Rd
Suite 100
Woodbury, MN 55125-4883
Phone (651) 578-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322001301 MN Part B Supplier - Clinic/Group Practice 7214212810 Receives reassigned benefits from 2 practitioners
Practice locations: Maplewood, MN; Forest Lake, MN; Woodbury, MN; Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

2945 Hazelwood St
Ste 300
Saint Paul, MN 55109
Phone (651) 471-9701

9950 Valley Creek Rd
Ste 100
Woodbury, MN 55125
Phone 6515787000 ext. 654

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1285179945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9950 VALLEY CREEK RD",
            "address_2": "SUITE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254883",
            "telephone_number": "651-578-7000",
            "fax_number": "651-578-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 VALLEY CREEK RD",
            "address_2": "SUITE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254883",
            "telephone_number": "651-578-7000",
            "fax_number": "651-578-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE NORTH ORAL SURGERY AND IMPLANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "ORAL SURGEON/PRESIDENT",
        "authorized_official_telephone_number": "651-578-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D9734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.