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OMS SPECIALISTS
NPI 1770694812
Dentist - Oral and Maxillofacial Surgery in Waconia, MN

Active since August 31, 2006
490 S MAPLE ST STE 102, WACONIA, MN 55387(952) 442-5448(952) 442-5496 Get Directions Write a Review

NPPES record last updated: July 29, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Oms Specialists NPPES

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

OMS SPECIALISTS (NPI 1770694812) is a healthcare organization registered as an oral and maxillofacial surgery in Waconia, Minnesota and active in the NPI registry since August 2006. The organization lists Kirby Charles Johnson, President, as its authorized official.

NPPES Registry Identity

NPI1770694812
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameORAL & MAXILLOFACIAL SURGERY SPECIALISTS, PA
Location Address490 S MAPLE ST STE 102Waconia, MN 55387-1762
Mailing Address550 County Road D, Suite 12New Brighton, MN 55112 · (651) 259-9902 · Fax (651) 259-9930
Phone(952) 442-5448
Fax(952) 442-5496
Organization SubpartNo
Authorized OfficialKirby Charles JohnsonPresident · (612) 788-9246
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 29, 2014
✔ NPI 1770694812 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.
490 S MAPLE ST STE 102, Waconia, MN 55387
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Other Names 1

Doing Business AsOms Specialists

Other Identifiers 4

Medicare UPINC07428MN
Medicare UPINT93145MN
Medicare UPINU72794MN
Medicare UPINU72187MN

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

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 & Maxillofacial Surgery Specialists, PA's NPI number?

The NPI number for Oral & Maxillofacial Surgery Specialists, PA is 1770694812. It was assigned to this organization in the NPPES registry on August 31, 2006. The provider is doing business as Oms Specialists.

Where is Oral & Maxillofacial Surgery Specialists, PA located?

Oral & Maxillofacial Surgery Specialists, PA is located at 490 S Maple St Ste 102, Waconia, MN 55387. The listed phone number is (952) 442-5448.

What is Oral & Maxillofacial Surgery Specialists, 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 & Maxillofacial Surgery Specialists, PA was last updated on July 29, 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.