Oral & Maxillofacial Surgery Specialists, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10472 Issued in MN

Legal business name

ORAL & MAXILLOFACIAL SURGERY SPECIALISTS, PA

Practice address

550 County Road D
Suite 12
New Brighton, MN 55421

Phone

(612) 788-9246

Fax

(612) 788-5511

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Kirby Charles Johnson, DDS

Title

President

Phone

(612) 788-9246

Specialties & licenses 1

Addresses

Other names 1

• OMS Specialists Doing business as

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1982634010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 COUNTY ROAD D",
            "address_2": "SUITE 12",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-259-9902",
            "fax_number": "651-259-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 COUNTY ROAD D",
            "address_2": "SUITE 12",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55421",
            "telephone_number": "612-788-9246",
            "fax_number": "612-788-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & MAXILLOFACIAL SURGERY SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-788-9246",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "10472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMS Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Floyd William Olsen, D.C.
• Jaclyn E Olson
• Judith Akeyo Ondoro
• Colleen Marie Oneil, LADC
• David A Ong, DDS
• Christine Osgood, LMFT
• Elizabeth Ostby, MA
• Meghan Osterbauer, LMFT
• Otter Tail Health Care Services LLC
• Egle Otto

• Oral and Maxillofacial Surgery (Dentist) in New Brighton, MN
• Providers in New Brighton, 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 29, 2014; 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.