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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
MN | Dental Providers |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326290727 | Bluestone Oral and Maxillofacial Surgery, P.a. | Dentist | 1616 Cloquet Ave, Cloquet, MN 55720-1948 | 2008-10-16 |
Street Address |
324 W SUPERIOR ST SUITE 720 |
City | DULUTH |
State | MN |
Zip Code | 55802-1701 |
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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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 |
Find all providers in zip 55802 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
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 |
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 |
Find all providers in DULUTH |
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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.