NPIMap

Organization Active NPI

Maxillofacial Imaging LLC

Doing business as Advanced Head & Neck Imaging

  • Radiology Clinic/Center
  • Roseville, MN
National Provider Identifier
1477712008
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MAXILLOFACIAL IMAGING LLC
Doing business as
Advanced Head & Neck Imaging
Practice address
2860 Snelling Ave N
Suite 2
Roseville, MN 55113-1438
Phone
(651) 636-3050
NPI assigned
Jun 9, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Jane Roach, RDH
Title
Manager
Phone
(651) 636-3050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

2860 Snelling Ave N
Suite 2
Roseville, MN 55113-1438

Mailing address

2860 Snelling Ave N
Suite 2
Roseville, MN 55113-1438
Phone (651) 636-3050

Other names 1

  • Advanced Head & Neck Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Head Neck Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2860 Snelling Ave N
Ste 2
Roseville, MN 55113
Phone (651) 636-3050

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1477712008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 SNELLING AVE N",
            "address_2": "SUITE 2",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131438",
            "telephone_number": "651-636-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 SNELLING AVE N",
            "address_2": "SUITE 2",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131438",
            "telephone_number": "651-636-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLOFACIAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "651-636-3050",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Head & Neck Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.