Paul A. Vollmer, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D11126 Issued in MN

Practice address

1420 Lake St S Ste 200
Forest Lake, MN 55025-2713

Phone

(651) 578-7000

Fax

(651) 464-8013

NPI assigned

Mar 9, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

University of Missouri St Louis - School of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

True North Oral Surgery and Implants PLLCGroup PAC ID 7214212810, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• True North Oral Surgery and Implants PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodbury, MN
  • NPI 1285179945
  Medicare reassignment Care Compare group NPD
• Maplewood Oral and Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodbury, MN
  • NPI 1003993304
  NPD (past)
• Siouxland Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Sioux Falls, SD
  • NPI 1790757011
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710955547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9950 VALLEY CREEK RD STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255803",
            "telephone_number": "651-578-7000",
            "fax_number": "651-578-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LAKE ST S STE 200",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252713",
            "telephone_number": "651-578-7000",
            "fax_number": "651-464-8013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9950 Valley Creek Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551255803",
            "country_code": "US",
            "telephone_number": "651-578-7000 x654",
            "fax_number": "651-578-0157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1560 Beam Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091171",
            "country_code": "US",
            "telephone_number": "651-578-7000",
            "fax_number": "651-773-9646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "PAUL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D11126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIROAD MEDICARE",
            "identifier": "1900010487",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny Valkos, MSW, LICSW, LADC
• Ellen Van Tassel, MA, CCC-SLP
• Rebecca Varoga, PT, DPT
• Raymond Keith Vellenga, RPH
• David Armin Vetter Jr.
• Kristan Voss, LPCC
• Steven Henry Voss, MD
• Kileigh Wagener
• Wal-Mart Stores, Inc. (Vision Center 30-2274)
• Waldoch Crafts, Inc.

• Oral and Maxillofacial Surgery (Dentist) in Forest Lake, MN
• Providers in Forest Lake, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.