DR. THOMAS HEIDENREICH (D.D.S.) – Oral and Maxillofacial Surgery (Dentist), NPI 1720367394
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
58 MAXILLOFACIAL SURGERY in IL
Provider Addresses for DR. THOMAS HEIDENREICH (D.D.S.)
375TH MEDICAL GROUP
310 WEST LOSEY STREET
SCOTT AFB, IL 62225
Phone:
Type: Mailing
3950 VETERANS DR STE 100
SAINT CLOUD, MN 563033424
Phone: (320) 252-3611
Type: Location
CENTRASOTA ORAL SURGEONS
3950 VETERANS DRIVE, SUITE 100
ST. CLOUD, MN 56303
Phone: (320) 252-3611
Fax: (320) 252-7574
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2023-02-06 • Largest payer in this snapshot: ZIMVIE INC. ($36).
Total Amount
$36
General + Research + Ownership
Payments
1
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ZIMVIE INC. | $36 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-05-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220504000318 | I | Maxillofacial Surgery | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62225)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E N T I S T | MN | |
| D E N T I S T | MN | |
| D E N T I S T | MN | |
| Oral Surgery | MN | |
| - | MN | |
| Dentist, Oral Surgery | MN |
Reviews
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