MINNESOTA HEAD AND NECK SURGERY PLLC (NPI# 1982242061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982242061 |
| Entity Type | Organization |
| Organization Name | MINNESOTA HEAD AND NECK SURGERY PLLC |
| Practice Address |
2380 Troop Dr Unit 202 Sartell MN 56377-4637 |
| Practice Telephone | 3202579555 |
| Mailing Telephone | 3202579555 |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | DEEPAK KADEMANI (OWNER) |
| Authorized Official Telephone | 3202579555 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
2380 TROOP DR UNIT 202 |
| City | SARTELL |
| State | MN |
| Zip Code | 56377-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659787380 | Julie Kline | Nurse Practitioner | 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 | 2014-07-02 |
| 1194363275 | Minnesota Oral and Facial Surgery Pllc | Oral & Maxillofacial Surgery | 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 | 2019-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783515 | Chae Norman | Massage Therapist | 303 4th Ave S, Suite C, Sartell, MN 56377 | 2019-07-25 |
| 1497317259 | Stephanie Maria Schaefer | Behavioral Analyst | 1133 Mockingbird Loop, Sartell, MN 56377 | 2019-07-02 |
| 1538722848 | Madison Toughill | Behavior Technician | 205 14th Ave E, Sartell, MN 56377 | 2019-04-22 |
| 1902388671 | Julie Ann Helms | Counselor | 101 Dehler Dr., Sartell, MN 56377 | 2018-08-30 |
| 1104337617 | Louis Chester Winskowski IIi | Orthotist | 50 14th Ave E Suite 114, Sartell, MN 56377 | 2017-10-24 |
| 1962958611 | Centracare Clinic | Exclusive Provider Organization | 166 19th Street S, Suite 202, Sartell, MN 56377 | 2016-08-31 |
| 1295197846 | Mindful Healing & Training | Counselor | 1417 15th Street South, Sartell, MN 56377 | 2016-03-23 |
| 1710342894 | Saint Cloud Hospital St. Benedict's Senior Community | Skilled Nursing Facility | 990 19th St. S., Sartell, MN 56377 | 2015-12-16 |
| 1932452661 | David Peter Pogatchnik | Pharmacist | 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 | 2012-10-18 |
| 1669759866 | Lakewood Health System | Clinic/Center | 161 19th St S Ste 106, Sartell, MN 56377 | 2011-11-16 |
| Find all providers in zip 56377 | ||||
| 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 |
|---|---|---|---|---|
| 1194363275 | Minnesota Oral and Facial Surgery Pllc | Oral & Maxillofacial Surgery | 2380 Troop Dr Unit 202, Sartell, MN 56377-4637 | 2019-12-19 |
| 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 |
| 1588823983 | Jacob Gregory Yetzer | Oral & Maxillofacial Surgery | 3366 Oakdale Ave N Ste 200, Robbinsdale, MN 55422-2962 | 2008-06-02 |
| 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 |
| 1245582063 | Brent L Florine, Dds, Pllc | Oral & Maxillofacial Surgery | 4151 Knob Dr Ste 101, Eagan, MN 55122-1876 | 2012-10-03 |
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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.