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NORTHERN STAR ORAL AND MAXILLOFACIAL SURGERY PLLC
NPI 1699901140
Clinic/Center - Oral and Maxillofacial Surgery in St Louis Park, MN

Active since June 10, 2009
5100 GAMBLE DR, SUITE 125, ST LOUIS PARK, MN 55416(952) 465-0105(952) 465-0106 Get Directions Write a Review

NPPES record last updated: June 23, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Northern Star Oral And Maxillofacial Surgery Pllc NPPES

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

NORTHERN STAR ORAL AND MAXILLOFACIAL SURGERY PLLC (NPI 1699901140) is a healthcare organization registered as an oral and maxillofacial surgery in St Louis Park, Minnesota and active in the NPI registry since June 2009. The organization lists Julie A Chavez, Owner, as its authorized official.

NPPES Registry Identity

NPI1699901140
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameNORTHERN STAR ORAL AND MAXILLOFACIAL SURGERY PLLC
Location Address5100 GAMBLE DR, SUITE 125St Louis Park, MN 55416-1585
Mailing Address5100 Gamble Dr, Suite 125St Louis Park, MN 55416-1585 · (952) 465-0105 · Fax (952) 465-0106
Phone(952) 465-0105
Fax(952) 465-0106
Organization SubpartNo
Authorized OfficialJulie A ChavezOwner · (952) 465-0105
Enumeration DateJune 10, 2009
Last NPPES UpdateJune 23, 2014
✔ NPI 1699901140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
License✔ Licensed in MN · D11399
Definition
An oral and maxillofacial surgery clinic or center 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.
5100 GAMBLE DR, St Louis Park, MN 55416
Open in Google Maps ↗

Other Identifiers 4

OtherDQ4459MN · Medicare Railroad Ptan
Other187847MN · U Care
Other3AI37NOMN · Blue Cross Blue Shield
OtherCO5268MN · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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)

Northern Star Oral And Maxillofacial Surgery Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Northern Star Oral And Maxillofacial Surgery PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Julie Chavez, DDS
Dentist
NPI 1851364392
5100 GAMBLE DR SUITE 125
St Louis Park, MN 55416
(952) 465-0105
✔ 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 Northern Star Oral And Maxillofacial Surgery PLLC's NPI number?

The NPI number for Northern Star Oral And Maxillofacial Surgery PLLC is 1699901140. It was assigned to this organization in the NPPES registry on June 10, 2009.

Where is Northern Star Oral And Maxillofacial Surgery PLLC located?

Northern Star Oral And Maxillofacial Surgery PLLC is located at 5100 Gamble Dr Suite 125, St Louis Park, MN 55416. The listed phone number is (952) 465-0105.

What is Northern Star Oral And Maxillofacial Surgery PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

Is Northern Star Oral And Maxillofacial Surgery PLLC enrolled in Medicare?

Yes. Northern Star Oral And Maxillofacial Surgery PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northern Star Oral And Maxillofacial Surgery PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dentist) reassigns their Medicare billing to Northern Star Oral And Maxillofacial Surgery PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Northern Star Oral And Maxillofacial Surgery PLLC accept?

Health plans from UnitedHealthcare list Northern Star Oral And Maxillofacial Surgery PLLC 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 Northern Star Oral And Maxillofacial Surgery PLLC was last updated on June 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.