CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. – Oral and Maxillofacial Surgery (Dentist), NPI 1598710477

CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. is a healthcare provider. based in Saint cloud, Minnesota. specializing in Oral and Maxillofacial Surgery (Dentist). The NPI Number for CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. is 1598710477

Main info

Organization
Name
CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.
NPI
1598710477
Phone
(320) 252-3611
Address
3950 VETERANS DR
Authorized Official
ROBERT J KECK PRESIDENT D.D.S., M.S.
Enumeration Date
22 May 2006
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.

  • 3950, Veterans Drive, St. Cloud, Stearns County, Minnesota, 56303, United States

    SUITE 100

    SAINT CLOUD, MN 563033410

    Phone: (320) 252-3611

    Fax: (320) 252-7574

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2006-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-10-31 (224 days ago).

Enrollment records

1

Earliest due date

2025-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20060110000046OClinic/Group PracticeMN2025-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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 56303)

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Reviews

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Frequently asked questions

What is the registry number for CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.?
The registry entry for CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. shows NPI 1598710477.
Is CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.'s NPI status active today?
Active status means CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.'s NPI record is not deactivated in the public file.
What type of care does CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. provide?
CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A.'s profile centers on Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Can patients visit CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A. in Saint Cloud, Minnesota?
For routing, start with Saint Cloud, Minnesota for CENTRASOTA ORAL & MAXILLOFACIAL SURGEONS, P.A., then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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