NPIMap

Organization Active NPI

Twin Cities Oral & Maxillofacial Surgery PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Apple Valley, MN
National Provider Identifier
1821299041
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
TWIN CITIES ORAL & MAXILLOFACIAL SURGERY PA
Practice address
14635 Pennock Ave
#250
Apple Valley, MN 55124-6430
Phone
(952) 432-1514
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shirley Herding
Title
Office Manager
Phone
(952) 432-1514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

14635 Pennock Ave
#250
Apple Valley, MN 55124-6430

Mailing address

925 Highway 55
Ste 202
Hastings, MN 55033-3734
Phone (651) 437-3262

National Provider Directory

National Provider Directory
Tax ID family
Twin Cities Oral Maxillofacial Surgery PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821299041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 HIGHWAY 55",
            "address_2": "STE 202",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550333734",
            "telephone_number": "651-437-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14635 PENNOCK AVE",
            "address_2": "#250",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246430",
            "telephone_number": "952-432-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES ORAL & MAXILLOFACIAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERDING",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-432-1514"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • 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.