NPIMap

Organization Active NPI

Family Oral Surgery Specialists, PLC

Doing business as Metro Dentalcare Specialty Center Burnsville - Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Burnsville, MN
National Provider Identifier
1407505829
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FAMILY ORAL SURGERY SPECIALISTS, PLC
Doing business as
Metro Dentalcare Specialty Center Burnsville - Oral Surgery
Practice address
14344 Burnhaven Dr
Burnsville, MN 55306-4928
Phone
(612) 638-1238
Fax
(952) 898-4109
NPI assigned
Mar 22, 2022
Organization subpart
Yes
Parent organization
FAMILY ORAL SURGERY SPECIALISTS, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

14344 Burnhaven Dr
Burnsville, MN 55306-4928

Mailing address

14344 Burnhaven Dr
Burnsville, MN 55306-4928
Phone (612) 638-1238

Other names 1

  • Metro Dentalcare Specialty Center Burnsville - Oral Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Oral Surgery Specialists PLC5 organizations share this tax ID, including this one
Part of
Family Oral Surgery Specialists PLC

Other organizations with this tax ID 4

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": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1407505829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14344 BURNHAVEN DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064928",
            "telephone_number": "612-638-1238",
            "fax_number": "952-898-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14344 BURNHAVEN DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064928",
            "telephone_number": "612-638-1238",
            "fax_number": "952-898-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ORAL SURGERY SPECIALISTS, PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY ORAL SURGERY SPECIALISTS, PLC",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare Specialty Center Burnsville - Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.