Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Great Lakes Oral & Maxillofacial Surgery, P.A.

Oral and Maxillofacial Surgery (Dentist) in New Richmond, WI · enumerated 2010 · authorized official Connie Miller, Practice Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1205136074

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Registry record

Entity type Organization (Type 2)

Legal business name Great Lakes Oral & Maxillofacial Surgery, P.A.

Practice address 227 Meridian Dr # 6, New Richmond, WI, 54017

Phone (715) 246-5150

Fax (715) 246-5102

Enumeration date Oct 27, 2010

Last updated in NPPES Oct 27, 2010

Taxonomy & classification

1223S0112X Oral and Maxillofacial Surgery (Dentist) Dental Providers · License 4482 (WI) Primary

Authorized official

Name Connie Miller

Title Practice Manager

Phone (651) 351-1010

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Great Lakes Oral & Maxillofacial Surgery, P.A. located?

The practice location on file with NPPES is in New Richmond, WI.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2010-10-27. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-10-27.