MARVIN VALLEJO (NPI# 1083078554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083078554 |
| Entity Type | Individual |
| Full Name | MARVIN VALLEJO |
| Practice Address |
200 1st St Sw Rochester MN 55905-0001 |
| Practice Telephone | 5072842511 |
| Mailing Telephone | 5072842511 |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D13719 | MN | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 68180 | MN | Allopathic & Osteopathic Physicians |
| N | 204E00000X | Oral & Maxillofacial Surgery | 29838 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
200 1ST ST SW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55905-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031875 | Christine Maria Miller | Radiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-05-27 |
| 1184225898 | Ellen Renne Larkin | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-08 |
| 1972104180 | Malinda Marie Wilcox | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1720689920 | Tammy Lynn Perttula | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1619578721 | Aaron Anderson | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-04 |
| 1093316598 | Rebecca Lea Parttridge | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-03 |
| 1710588173 | Eduardo Gabriel Danduch | Student in an Organized Health Care Education/Training Program | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-11-03 |
| 1962002030 | Taylor Jeanne Jamison | Physical Therapist | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-28 |
| 1619577640 | Hayden Taylor Middleton | Student in an Organized Health Care Education/Training Program | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-28 |
| 1295335461 | Vivek Sureshchandran Tharayil | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2020-10-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306333109 | John Warren Kirby | Radiology | 200 1st St Sw # 507284, Rochester, MN 55905 | 2018-04-17 |
| 1720528417 | Erin Hamilton | Social Worker | 200 First St. Sw, Rochester, MN 55905 | 2017-03-01 |
| 1033482872 | Mayo Foundation for Medical Education & Research | Durable Medical Equipment & Medical Supplies | 200 1st St Sw Ste S148, Rochester, MN 55905 | 2012-02-09 |
| 1871829937 | Karen Christine Lundholm | Pharmacist | 1216 2nd Street Sw, Rochester, MN 55905 | 2009-10-26 |
| 1689800260 | Matthew Basiaga | Pediatrics | 200 1st Ave Ne, Rochester, MN 55905 | 2009-06-09 |
| 1366680720 | Megan H. Nelson | Surgery | 200 First Street S.w., Rochester, MN 55905 | 2009-01-23 |
| 1639352198 | Jill Marie Hunchis | Nurse Practitioner | 200 First St Sw, Rochester, MN 55905 | 2007-12-07 |
| 1619027265 | Thomas Phillip Moyer | Spec/Tech, Pathology | 200 1st Street Southwest, H-730d, Rochester, MN 55905 | 2007-01-12 |
| 1568544070 | Lisa Ann Schimmenti | Medical Genetics | 200 1st Swst, Rochester, MN 55905 | 2006-10-20 |
| 1558302315 | Robert J Pignolo | Internal Medicine | 200 1st Street Sw, Rochester, MN 55905 | 2006-06-10 |
| Find all providers in zip 55905 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326296120 | Dan E Tolman | Oral & Maxillofacial Surgery | 2709 Merrihills Dr Sw, Rochester, MN 55902-1168 | 2008-09-04 |
| 1114489101 | Michelle Grayson | Oral & Maxillofacial Surgery | 1455 E Ridge Rd, Rochester, NY 14621-2006 | 2019-04-01 |
| 1659635514 | Jeff Allen Kohlmeier | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-06-26 |
| 1356604508 | Brett J Bezak | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-06-22 |
| 1629337506 | Christopher Streff | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2012-05-11 |
| 1578858080 | Li-ping Chew | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2011-06-13 |
| 1457583742 | Stephen Matthew Davis | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2009-08-20 |
| 1336397587 | William J Fillmore | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-08-29 |
| 1710940788 | Warren C Hammert | Oral & Maxillofacial Surgery | 601 Elmwood Ave, Rochester, NY 14642 | 2006-04-10 |
| 1548234578 | Christopher F Viozzi | Oral & Maxillofacial Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-02-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.