JACOB GREGORY YETZER (NPI# 1588823983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588823983 |
| Entity Type | Individual |
| Full Name | JACOB GREGORY YETZER |
| Credential | M.D., D.D.S |
| Practice Address |
3366 Oakdale Ave N Ste 200 Robbinsdale MN 55422-2962 |
| Mailing Address |
200 1st St Sw Rochester MN 55905-0001 |
| Practice Telephone | 7635815360 |
| Practice Fax Number | 7635815361 |
| Mailing Telephone | 5072842511 |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2019-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | ME119107 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003147783A | 05 | |
| FL | 011938600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| Street Address |
3366 OAKDALE AVE N STE 200 |
| City | ROBBINSDALE |
| State | MN |
| Zip Code | 55422-2962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447400312 | Lemuel R Vawter | Hospitalist | 3366 Oakdale Ave N Ste 200, Ms 33500a-141, Robbinsdale, MN 55422-2962 | 2008-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966794 | Trevor Velin | Chiropractor | Robin Center Chiropractic, Pa, 4080 W Broadway Ave, 310, Robbinsdale, MN 55422 | 2019-11-07 |
| 1780165134 | American Current Care of Minnesota PC | Clinic/Center | 4080 W Broadway Ave Ste 200, Robbinsdale, MN 55422 | 2018-08-23 |
| 1366928426 | Creekside Family Dental Pllc | Dentist | Giebenhain Dental Associates, P.a., 5851 Duluth Street # 103, Golden Valley, MN 55422 | 2018-07-12 |
| 1497249536 | Luke Utecht | Psychologist | 4150 Olson Memorial Hwy, Suite 420, Golden Valley, MN 55422 | 2018-06-21 |
| 1821582115 | Ajaa Oliver | Registered Nurse | 3606 Zenith Ave N, Robbinsdale, MN 55422 | 2018-06-19 |
| 1306348024 | Leila Jean Erlandson | Marriage & Family Therapist | Golden Valley Executive Center, 4284 Dahlberg Drive, Golden Valley, MN 55422 | 2018-03-08 |
| 1467969907 | Minneapolis Health Clinic Pllc | Internal Medicine | 4825 Olson Memorial Hwy., Suite 101, Golden Valley, MN 55422 | 2018-01-05 |
| 1275049116 | Lake Town Homecare, LLC | In Home Supportive Care | 4119 Scott Ave N, Robbinsdale, MN 55422 | 2017-12-14 |
| 1750894002 | Unihealth Home Care, LLC | Home Health | 1710 Douglas Dr N Ste 226j, Golden Valley, MN 55422 | 2017-11-08 |
| 1194172296 | Crosscultural Health Care Inc | Home Health | 5801 Duluth Street Suite 310, Golden Valley, MN 55422 | 2016-05-18 |
| Find all providers in zip 55422 | ||||
| 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 |
|---|---|---|---|---|
| 1649630609 | Kyle Burton Tyler | Oral & Maxillofacial Surgery | 515 Delaware St Se 7-314 Moos Tower, Minneapolis, MN 55455-0357 | 2016-03-02 |
| 1326296120 | Dan E Tolman | Oral & Maxillofacial Surgery | 2709 Merrihills Dr Sw, Rochester, MN 55902-1168 | 2008-09-04 |
| 1992848808 | Christopher Michael De La Mater | Oral & Maxillofacial Surgery | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-14 |
| 1518070648 | Joseph H Wang | Oral & Maxillofacial Surgery | 1101 First St S, Willmar, MN 56201 | 2006-08-15 |
| 1821010497 | Maxillofacial and Oral Surgery Pa | Oral & Maxillofacial Surgery | 7-174 Moos Tower, 515 Delaware Street Se, Minneapolis, MN 55155-0329 | 2006-07-24 |
| 1104898626 | David L Basi | Oral & Maxillofacial Surgery | 515 Delaware St Se, 7-174 Moos Tower, Minneapolis, MN 55455 | 2006-02-07 |
| 1710958368 | Paul F Bruer | Oral & Maxillofacial Surgery | 3209 West 76th Street, #303, Edina, MN 55435 | 2006-01-31 |
| 1144205626 | Lawrence A Palmersheim | Oral & Maxillofacial Surgery | 625 E Nicollet Blvd, Ste 205, Burnsville, MN 55337-6734 | 2005-12-07 |
| 1194363275 | Minnesota Oral and Facial Surgery Pllc | Oral & Maxillofacial Surgery | 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 | 2019-12-19 |
| 1982242061 | Minnesota Head and Neck Surgery Pllc | Oral & Maxillofacial Surgery | 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
| City | ROBBINSDALE |
| Zip Code | 55422 |
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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.