ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES (NPI# 1679668529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679668529 |
| Entity Type | Organization |
| Organization Name | ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES |
| Practice Address |
813 S Pokegama Ave Grand Rapids MN 55744-3934 |
| Mailing Address |
813 Pokegama Avenue South Grand Rapids MN 55744 |
| Practice Telephone | 2187221854 |
| Practice Fax Number | 2187226424 |
| Mailing Telephone | 2183260349 |
| Mailing Fax Number | 2183265005 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-09-04 |
| Authorized Official Name | DR. PAUL KEVIN HODAPP (PRESIDENT/PARTNER) |
| Authorized Official Telephone | 2187221854 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 861461000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417042367 | Oral and Maxillofacial Surgical Associates | Dentist | 214 N 5th Ave, Virginia, MN 55792-2436 | 2006-10-04 |
| 1003900994 | Oral and Maxillofacial Surgical Associates | Dentist | 3712 Tower Ave, Suite E, Superior, WI 54880-5567 | 2006-10-03 |
| 1700971652 | Oral and Maxillofacial Surgical Associates | Dentist | 2860 Piedmont Ave, Duluth, MN 55811-2938 | 2006-10-04 |
| 1104911056 | Oral and Maxillofacial Surgical Associates | Dentist | 1000 East First Street #302, Duluth, MN 55805-2297 | 2006-10-04 |
| Street Address |
813 S POKEGAMA AVE |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| 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 |
|---|---|---|---|---|
| 1730440983 | Igor Makovey | Dentist | 4500 Cascade Rd Se Ste 208, Grand Rapids, MI 49546-3665 | 2012-06-05 |
| 1598084147 | Bradley Michael Robinson | Dentist | 200 43rd Street Se, Suite D, Grand Rapids, MI 49508 | 2010-05-21 |
| 1184885154 | Mark Jesin | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546 | 2008-06-22 |
| 1629140116 | Robert John Rosema | Dentist | 2017 Eastcastle Dr Se, Suite C, Grand Rapids, MI 49508 | 2006-11-14 |
| 1003908575 | Robert L Kintz | Dentist | 2144 E Paris Ave Se, Suite 150, Grand Rapids, MI 49546-6111 | 2006-09-29 |
| 1740371087 | Richard W Panek | Dentist | 4349 Sawkaw Dr Ne, Grand Rapids, MI 49525-1768 | 2006-09-28 |
| 1033223250 | Oral Surgery Associates, PC | Dentist | 2144 E Paris Ave Se Ste 150, Grand Rapids, MI 49546-6126 | 2006-08-17 |
| 1427002377 | David R Dalrymple | Dentist | 550 3 Mile Rd Nw, Grand Rapids, MI 49544-8207 | 2006-05-22 |
| 1508324732 | Advanced Oral Surgery, Pllc | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546-6147 | 2019-03-06 |
| 1992945943 | Alpine Oral Surgery PC | Dentist | 550 3 Mile Rd Nw, Grand Rapids, MI 49544-8207 | 2009-03-04 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES.
| 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.