OrganizationActive
St Paul Oral Surgery and Dental Implants LLC
NPI 1124776687 · Oral and Maxillofacial Surgery (Dentist) · Mendota Heights, MN
Provider details
- NPI number
- 1124776687
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Parent organization
- St Paul Oral Surgery and Dental Implants LLC
- Organization subpart
- Yes
- Authorized official
- Celia Hayes, Credentialing Coordinator(217) 540-2100
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
750 Main St Ste 200
Mendota Heights, MN 55118-3767
Phone: (651) 451-1873
Fax: (651) 451-8010
Street-level locationGet directions
Mailing address
750 Main St Ste 200
Mendota Heights, MN 55118-3767
Other names (DBA / former)
- Doing business as
- St. Paul Oral Surgery - Mendota Heights
Registry dates
- Enumerated
- 2022-03-14
- Last updated
- 2022-03-14
- Certified
- 2022-03-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.