BLUESTONE ORAL AND MAXILLOFACIAL SURGERY, P.A.


Address: 324 W Superior St, Suite 720, Duluth, MN 55802-1701
Phone: 2187278994

BLUESTONE ORAL AND MAXILLOFACIAL SURGERY, P.A. (NPI# 1578511572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578511572
Entity Type Organization
Organization Name BLUESTONE ORAL AND MAXILLOFACIAL SURGERY, P.A.
Practice Address 324 W Superior St
Suite 720
Duluth
MN 55802-1701
Practice Telephone 2187278994
Practice Fax Number 2187278995
Mailing Telephone 2187278994
Mailing Fax Number 2187278995
Enumeration Date 2006-05-04
Last Update Date 2020-08-22
Authorized Official Name MRS. JEAN DIANE SOUTHWORTH (BUSINESS ADMINISTRATOR)
Authorized Official Telephone 2187278994
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
MN Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN UNITED CONCORDIA (CLOQUET 01630538 01
MN UNITED CONCORDIA (DULUTH) 01630541 01
MN BLUE CROSS/BLUE SHIELD MN 6B297JE 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1326290727 Bluestone Oral and Maxillofacial Surgery, P.a. Dentist 1616 Cloquet Ave, Cloquet, MN 55720-1948 2008-10-16

Office Location

Street Address 324 W SUPERIOR ST
SUITE 720
City DULUTH
State MN
Zip Code 55802-1701

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073517447 Eileen E. Patterson Dentist 324 W Superior St, Ste 1130, Duluth, MN 55802-1714 2005-06-13
1669087797 Center for Family Wellness Marriage & Family Therapist 324 W Superior St, 828 Medical Arts Building, Duluth, MN 55802-1701 2020-09-15
1639789019 Illume North, LLC Psychologist 324 W Superior St, 630 Medical Arts, Duluth, MN 55802-1701 2020-07-31
1861038176 Erin Elizabeth Devaney Therrien Social Worker 324 W Superior St, Duluth, MN 55802-1701 2019-11-21
1316430002 Paul Raymond Baecker Counselor 324 W Superior St, Duluth, MN 55802-1701 2018-06-07
1194275537 Andrea Wells Counselor 324 W Superior St, Duluth, MN 55802-1701 2016-10-10
1215480660 North Shore Mental Health Services LLC Counselor 324 W Superior St, Suite 911, Duluth, MN 55802-1701 2016-08-02
1518321710 Nathan G Halstead Dds Ms PC Dentist 324 W Superior St, Suite 100, Duluth, MN 55802-1701 2016-04-13
1740669704 Northwoods Counseling Center LLC Psychologist 324 W Superior St, Suite 911, Duluth, MN 55802-1701 2015-05-23
1134522527 Adam Ries Psychologist 324 W Superior St, Suite 600, Duluth, MN 55802-1701 2014-09-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063915239 Jpw Counseling & Consultation Social Worker 302 W Superior St Ste 508, Duluth, MN 55802 2018-03-14
1134664311 Amp Group, LLC Counselor 331 West Superior Street, Duluth, MN 55802 2016-12-27
1982151361 Tiffany Riester Counselor 332 W Superior Street, Suite 300, Duluth, MN 55802 2016-09-02
1730635392 Karina Krosbakken Counselor 332 W. Superior St., Suite 300, Duluth, MN 55802 2016-09-01
1437559051 Natalie R Zwak Dietitian, Registered 26 E Superior St Ste 315, Duluth, MN 55802 2014-09-02
1447679279 Valerie Lou Shelton Registered Nurse 118 E Superior St., Duluth, MN 55802 2014-04-09
1285063115 Brian Bergstedt Counselor 332 West Superior Street, Suite 300, Duluth, MN 55802 2013-11-01
1508135948 Karen Dee Turner Counselor 202 W. Superior Street, Suite 700, Duluth, MN 55802 2011-12-14
1497023410 Jean Barrie Mcbride Pharmacist 1131 East Superior Street, Duluth, MN 55802 2011-12-05
1194092304 Diane Murphy Winship Pharmacist 1331 Superior St, Duluth, MN 55802 2011-11-17
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1598370454 Karin Davis, Dmd, PC Dentist 3630 Savannah Pl Ste 250, Duluth, GA 30096-6394 2020-09-08
1922193770 Thomas Richard Seidelmann Dentist 1000 E 1st St Ste 302, Duluth, MN 55805-2297 2006-10-04
1801981444 John Rodman Cornell Dentist 1000 East First Street #302, Duluth, MN 55805-2297 2006-10-03
1750475299 Paul Kevin Hodapp Dentist 1000 E 1st St Ste 108, Duluth, MN 55805-2297 2006-10-02
1255505996 Scott Kenneth Varland Dentist 1000 E 1st St Ste 108, Duluth, MN 55805-2297 2008-04-14
1356528558 Glen C Mcintosh D.d.s., P.C. Dentist 3400 Mcclure Bridge Road, Building G Suite B, Duluth, GA 30096 2008-01-30
1407059009 Joby E. Jaberi Dentist 1000 E 1st St, Suite 302, Duluth, MN 55805-2297 2007-06-09
1104976570 Peter J Mayer Dentist 3617 W Arrowhead Rd, Duluth, MN 55811-4046 2007-01-10
1457401820 Northern Oral & Maxillofacial Surgeons, Pa Dentist 3617 W Arrowhead Rd, Duluth, MN 55811-4046 2007-01-10
1679623029 Charles R Babst Dentist 3617 W Arrowhead Rd, Duluth, MN 55811-4046 2007-01-10
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Competitor

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City DULUTH
Zip Code 55802

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Dataset Information

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.

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