NPIMap

Organization Active NPI

Family Oral Surgery Specialists, PLC

Doing business as Metro Dentalcare Blaine 10

  • Oral and Maxillofacial Surgery (Dentist)
  • Blaine, MN
National Provider Identifier
1730838186
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FAMILY ORAL SURGERY SPECIALISTS, PLC
Doing business as
Metro Dentalcare Blaine 10
Practice address
261 County Road 10 NE Ste 10
Blaine, MN 55434-1020
Phone
(763) 786-9644
Fax
(763) 786-8602
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 Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

261 County Road 10 NE Ste 10
Blaine, MN 55434-1020

Mailing address

261 County Road 10 NE Ste 10
Blaine, MN 55434-1020
Phone (763) 786-9644

Other names 1

  • Metro Dentalcare Blaine 10 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.

Locations

261 County Road 10 NE
Ste 10
Blaine, MN 55434
Phone (763) 786-9644

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": "1730838186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 COUNTY ROAD 10 NE STE 10",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341020",
            "telephone_number": "763-786-9644",
            "fax_number": "763-786-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 COUNTY ROAD 10 NE STE 10",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341020",
            "telephone_number": "763-786-9644",
            "fax_number": "763-786-8602"
        }
    ],
    "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": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare Blaine 10",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, 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.