Northside Minnesota Oral and Maxillofacial Surgeons

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS

Practice address

11441 Osage St NW
Coon Rapids, MN 55433

Phone

(763) 862-6442

NPI assigned

Oct 12, 2007

Organization subpart

No

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

Authorized official

Name

Mohamed El Deeb

Title

Doctor/President

Phone

(763) 862-6442

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1336337526",
    "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": "55433"
        },
        {
            "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": "55433",
            "telephone_number": "763-862-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MINNESOTA ORAL AND MAXILLOFACIAL SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "EL DEEB",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "763-862-6442"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern OB GYN Associates PC
• Northern Pines Counseling Center, Inc.
• Northland Dental Partners, PLLC
• Northland Hearing Centers, Inc.
• Amanda Elizabeth Northrup, NP
• Northside Minnesota Oral and Maxillofacial Surgeons, PLLC
• Northstar Sleep Center LLC
• Northtown Psychology Associates LLC
• Northwest Passage High School
• Northwind Lung Specialists, P.a.

• Dentist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.