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ORAL AND MAXILLOFACIAL SURGERY ASSO OF EAU CLAIRE SC
NPI 1316954928
Oral & Maxillofacial Surgery in Altoona, WI

Active since August 03, 2006
788 OAKLEAF WAY, ALTOONA, WI 54720(715) 834-8414(715) 834-3557 Get Directions Write a Review

NPPES record last updated: July 26, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Oral And Maxillofacial Surgery Asso Of Eau Claire Sc NPPES

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

ORAL AND MAXILLOFACIAL SURGERY ASSO OF EAU CLAIRE SC (NPI 1316954928), doing business as Oral And Maxillofacial Surgery Associates Of Eau Claire Sc, is a healthcare organization registered as an oral & maxillofacial surgery in Altoona, Wisconsin and active in the NPI registry since August 2006. The organization lists Gina K Thor, Transcription And Credentialing, as its authorized official.

NPPES Registry Identity

NPI1316954928
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameORAL AND MAXILLOFACIAL SURGERY ASSO OF EAU CLAIRE SC
Location Address788 OAKLEAF WAYAltoona, WI 54720
Mailing Address1120 Oak Ridge DriveEau Claire, WI 54701 · (715) 834-8414 · Fax (715) 834-3557
Phone(715) 834-8414
Fax(715) 834-3557
Organization SubpartNo
Authorized OfficialGina K ThorTranscription And Credentialing · (715) 834-8414
Enumeration DateAugust 3, 2006
Last NPPES UpdateJuly 26, 2018
✔ NPI 1316954928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Licenses✔ Licensed in WI · 4495-015✔ Licensed in WI · 4680-015✔ Licensed in WI · 5112-015✔ Licensed in WI · 5563-015
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · EndodonticsTaxonomy 1223E0200X · License 6222-15 (WI), 4412-015 (WI)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X
788 OAKLEAF WAY, Altoona, WI 54720
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Other Names 1

Former Legal Business NameOral And Maxillofacial Surgery Associates Of Eau Claire Sc

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Oral And Maxillofacial Surgery Asso Of Eau Claire Sc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Mark Millington, D.D.S.
Oral Surgery
NPI 1205908936
788 OAKLEAF WAY
Altoona, WI 54720
(715) 834-8414
✔ PECOS✔ Accepts MedicareSame address
Slavko Ivankovic, D.D.S.
Oral Surgery
NPI 1639241342
788 OAKLEAF WAY
Altoona, WI 54720
(715) 834-8414
✔ PECOS✔ Accepts Medicare0.1 mi
William Grosdidier
Oral Surgery
NPI 1447605886
1100 WILFORD HALL LOOP BLDG 4554
Jbsa Lackland, TX 78236
(651) 468-9356
✔ PECOS✔ Accepts Medicare1,133 mi

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 Oral And Maxillofacial Surgery Asso Of Eau Claire Sc's NPI number?

The NPI number for Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is 1316954928. It was assigned to this organization in the NPPES registry on August 3, 2006. The provider was formerly known as Oral And Maxillofacial Surgery Associates Of Eau Claire Sc.

Where is Oral And Maxillofacial Surgery Asso Of Eau Claire Sc located?

Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is located at 788 Oakleaf Way, Altoona, WI 54720. The listed phone number is (715) 834-8414.

What is Oral And Maxillofacial Surgery Asso Of Eau Claire Sc's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Oral And Maxillofacial Surgery Asso Of Eau Claire Sc enrolled in Medicare?

Yes. Oral And Maxillofacial Surgery Asso Of Eau Claire Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Oral And Maxillofacial Surgery Asso Of Eau Claire Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Oral Surgery, reassign their Medicare billing to Oral And Maxillofacial Surgery Asso Of Eau Claire Sc. 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, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Oral And Maxillofacial Surgery Asso Of Eau Claire Sc accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, HealthPartners and Security Health Plan list Oral And Maxillofacial Surgery Asso Of Eau Claire Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Oral And Maxillofacial Surgery Asso Of Eau Claire Sc was last updated on July 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.