NPIMap

Organization Active NPI

Family Oral Surgery Specialists, PLC

Doing business as Metro Dentalcare Specialty Center Maple Grove - Oral Surgery

  • Oral and Maxillofacial Pathology Dentistry
  • Maple Grove, MN
National Provider Identifier
1497404818
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
FAMILY ORAL SURGERY SPECIALISTS, PLC
Doing business as
Metro Dentalcare Specialty Center Maple Grove - Oral Surgery
Practice address
15785 95TH Ave N
Maple Grove, MN 55369-4404
Phone
(763) 233-4141
Fax
(763) 420-3158
NPI assigned
Mar 22, 2022
Last updated
Mar 22, 2022By the provider in NPPES
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 Pathology Dentistry 1223P0106X NU Primary

Addresses

Primary practice location

15785 95TH Ave N
Maple Grove, MN 55369-4404

Mailing address

15785 95TH Ave N
Maple Grove, MN 55369-4404
Phone (763) 233-4141

Other names 1

  • Metro Dentalcare Specialty Center Maple Grove - 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1497404818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15785 95TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694404",
            "telephone_number": "763-233-4141",
            "fax_number": "763-420-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15785 95TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694404",
            "telephone_number": "763-233-4141",
            "fax_number": "763-420-3158"
        }
    ],
    "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": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare Specialty Center Maple Grove - Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, 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.