St. Paul Oral Surgery, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7933 Issued in MN

Legal business name

ST. PAUL ORAL SURGERY, P.A.

Practice address

710 19TH Ave N
Suite 300
South St Paul, MN 55075-1359

Phone

(651) 451-1873

Fax

(651) 451-8010

NPI assigned

May 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dale Victor Olson, D.D.S.NPI 1679662696

Title

President

Phone

(651) 451-1873

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Dale Victor Olson, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • South St Paul, MN
  • NPI 1679662696
  NPD (past) Authorized official
• Travis Allan Johnson, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodbury, MN
  • NPI 1841637295
  NPD (past)
• Levi Zarbano, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Paul, MN
  • NPI 1225458391
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548218910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 19TH AVE N",
            "address_2": "SUITE 300",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550751359",
            "telephone_number": "651-451-1873",
            "fax_number": "651-451-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 19TH AVE N",
            "address_2": "SUITE 300",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550751359",
            "telephone_number": "651-451-1873",
            "fax_number": "651-451-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PAUL ORAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-451-1873",
        "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": "7933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South St. Paul Family Chiropractic, LTD
• South St. Paul Fire Department
• Special School Dist 6 Dakota Co
• Thomas E Spray, DDS
• St Paul Primary Care (Park Ave Family Practice)
• Billie Jo Story, LPCC
• Amalo Imana Tarafa
• TDF Transportation LLC
• Charles Joseph Tentinger, D.D.S.
• Haben Tesfai

• Oral and Maxillofacial Surgery (Dentist) in South St Paul, MN
• Providers in South St Paul, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.