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ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES PA
NPI 1104911056
Dentist - Oral and Maxillofacial Surgery in Duluth, MN

Active since October 04, 2006
1000 E 1ST ST STE 108, DULUTH, MN 55805(218) 722-1854(218) 722-6424 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 6, 2025, Oct 1, 2024 (2 updates tracked since 2024).

About Oral And Maxillofacial Surgical Associates Pa NPPES

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

ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES PA (NPI 1104911056), doing business as Blue Water Oral And Facial Surgery, is a healthcare organization registered as an oral and maxillofacial surgery in Duluth, Minnesota and active in the NPI registry since October 2006. The organization lists Katherine Anne Lafleur, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1104911056
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES PA
Location Address1000 E 1ST ST STE 108Duluth, MN 55805-2297
Mailing Address1000 E 1st St Ste 108Duluth, MN 55805-2297 · (218) 722-1854 · Fax (218) 722-6424
Phone(218) 722-1854
Fax(218) 722-6424
Organization SubpartNo
Authorized OfficialKatherine Anne LafleurPractice Administrator · (218) 722-1854
Enumeration DateOctober 4, 2006
Last NPPES UpdateFebruary 6, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2025
✔ NPI 1104911056 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.
1000 E 1ST ST STE 108, Duluth, MN 55805
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Other Names 1

Doing Business AsBlue Water Oral And Facial Surgery

Other Identifiers 1

Medicaid998722300MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SCOTT KENNETH VARLAND DDS
Dentist (Oral and Maxillofacial Surgery)
1000 E 1ST ST STE 108
DULUTH, MN 55805
St. Louis County (218) 722-1854
ERIC BURGIN SCOTLAND DDS
Dentist (Oral and Maxillofacial Surgery)
1000 E 1ST ST STE 108
DULUTH, MN 55805
St. Louis County (218) 722-1854
DR. PAUL KEVIN HODAPP DDS
Dentist (Oral and Maxillofacial Surgery)
1000 E 1ST ST STE 108
DULUTH, MN 55805
St. Louis County (218) 722-1854

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 Oral And Maxillofacial Surgical Associates PA's NPI number?

The NPI number for Oral And Maxillofacial Surgical Associates PA is 1104911056. It was assigned to this organization in the NPPES registry on October 4, 2006. The provider is doing business as Blue Water Oral and Facial Surgery.

Where is Oral And Maxillofacial Surgical Associates PA located?

Oral And Maxillofacial Surgical Associates PA is located at 1000 E 1st St Ste 108, Duluth, MN 55805. The listed phone number is (218) 722-1854.

What is Oral And Maxillofacial Surgical Associates PA's specialty?

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

When was this NPI record last updated?

The NPPES record for Oral And Maxillofacial Surgical Associates PA was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.