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ST. PAUL ORAL SURGERY
NPI 1043870645
Dentist - Oral and Maxillofacial Surgery in Saint Paul, MN

Active since June 17, 2019
2550 UNIVERSITY AVE W STE 115N, SAINT PAUL, MN 55114(651) 645-6429(651) 645-8326 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 2, 2022, Jun 17, 2019 (2 updates tracked since 2019).

About St. Paul Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST. PAUL ORAL SURGERY (NPI 1043870645) is a healthcare organization registered as an oral and maxillofacial surgery in Saint Paul, Minnesota and active in the NPI registry since June 2019. The organization lists Celia Hayes, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1043870645
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameST PAUL ORAL SURGERY AND DENTAL IMPLANTS LLC
Location Address2550 UNIVERSITY AVE W STE 115NSaint Paul, MN 55114-1097
Mailing Address2550 University Ave W Ste 115nSaint Paul, MN 55114-1097 · (651) 645-6429 · Fax (651) 645-8326
Phone(651) 645-6429
Fax(651) 645-8326
Organization SubpartYes
Authorized OfficialCelia HayesCredentialing Coordinator · (217) 540-2100
Enumeration DateJune 17, 2019
Last NPPES UpdateMay 2, 20222 updates tracked since enumeration
NPPES CertifiedMay 2, 2022
✔ NPI 1043870645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in 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.
2550 UNIVERSITY AVE W STE 115N, Saint Paul, MN 55114
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Other Names 1

Doing Business AsSt. Paul Oral Surgery

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St. Paul Oral Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to St. Paul Oral Surgery, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Matthew Hutchinson, DDS
Maxillofacial Surgery
NPI 1497073969
2550 UNIVERSITY AVE W #115-N
Saint Paul, MN 55114
(651) 645-6429
✔ PECOSSame address
Levi Zarbano, DDS
Oral Surgery
NPI 1225458391
2550 UNIVERSITY AVE W STE 115N
Saint Paul, MN 55114
(651) 645-6429
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Paul Oral Surgery And Dental Implants LLC's NPI number?

The NPI number for St Paul Oral Surgery And Dental Implants LLC is 1043870645. It was assigned to this organization in the NPPES registry on June 17, 2019. The provider is doing business as St. Paul Oral Surgery.

Where is St Paul Oral Surgery And Dental Implants LLC located?

St Paul Oral Surgery And Dental Implants LLC is located at 2550 University Ave W Ste 115N, Saint Paul, MN 55114. The listed phone number is (651) 645-6429.

What is St Paul Oral Surgery And Dental Implants LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is St Paul Oral Surgery And Dental Implants LLC enrolled in Medicare?

Yes. St Paul Oral Surgery And Dental Implants LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St Paul Oral Surgery And Dental Implants LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to St Paul Oral Surgery And Dental Implants LLC, in Maxillofacial Surgery and Oral Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for St Paul Oral Surgery And Dental Implants LLC was last updated on May 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.