Unknown Individual – Oral and Maxillofacial Surgery (Dentist), NPI 1316926017
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Valley Creek Rd, Bielenberg Drive, Woodbury, Washington County, Minnesota, 55125, United States
WOODBURY, MN 551255803
Phone: (651) 578-7000
Fax: (651) 578-0157
Type: Mailing
1420 Lake St S Ste 200
Forest Lake, MN 550252713
Phone: (651) 578-7000
Fax: (651) 464-8013
Type: Location
1560 Beam Ave Ste E
Maplewood, MN 551091171
Phone: (651) 578-7000
Fax: (651) 773-9646
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $136.
Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Dentsply Sirona Inc ($67).
Total Amount
$136
General + Research + Ownership
Payments
5
Total payment records
General Amount
$136
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dentsply Sirona Inc | $67 |
| Envista Holdings Corporation | $50 |
| BioHorizons Implant Systems Inc. | $20 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 55125)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Oral Surgery, Maxillofacial Surgery | MN | |
| Oral Surgery, Maxillofacial Surgery | MN |
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