Institute of Facial Surgery St Paul

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

INSTITUTE OF FACIAL SURGERY ST PAUL

Practice address

1774 Cope Ave E
Suite 140
Maplewood, MN 55109-2662

Phone

(651) 774-9611

Fax

(651) 748-3704

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Kent Brunsoman, D.D.S., M.S.

Title

President

Phone

(651) 774-9611

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Keith Schulte, DDS,MSD

  • Prosthodontics
  • Maplewood, MN
  • NPI 1003830712
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689723686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 COPE AVE E",
            "address_2": "SUITE 140",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092662",
            "telephone_number": "651-774-9611",
            "fax_number": "651-748-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 COPE AVE E",
            "address_2": "SUITE 140",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092662",
            "telephone_number": "651-774-9611",
            "fax_number": "651-748-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF FACIAL SURGERY ST PAUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNSOMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-774-9611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hy-Vee Inc
• Jennifer Hystead
• Margaret Kay Iaizzo, PT
• Qali Mohamed Ibrahim
• Richard Chima Ikeri Sr.
• Institute of Facial Surgery St Paul, PLLC
• Interactive Therapy Services, Inc.
• Nadeem Iqbal, M.D.
• Isd 622 Gladstone Meals on Wheels
• Alexander Ivaskovic, MD

• Oral and Maxillofacial Surgery (Dentist) in Maplewood, MN
• Providers in Maplewood, 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.