Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Great Lakes Oral & Maxillofacial Surgery, P.A.

Oral and Maxillofacial Surgery (Dentist) in Stillwater, MN · enumerated 2007 · authorized official Connie Miller, Practice Manager.

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

National Provider Identifier

1508058322

Verified

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Registry record

Entity type Organization (Type 2)

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

Other name <Unavail>

Practice address 2850 Curve Crest Blvd, Suite 130, Stillwater, MN, 55082

Phone (651) 351-1010

Fax (651) 351-9333

Enumeration date Aug 15, 2007

Last updated in NPPES Oct 20, 2010

Taxonomy & classification

1223S0112X Oral and Maxillofacial Surgery (Dentist) Dental Providers · License 10762 (MN) Primary

Authorized official

Name Connie Miller

Title Practice Manager

Phone (651) 351-1010

Other identifiers

Identifier	Type	State	Issuer
33714200	Other	WI	MEDICAL ASSISTANCE
CC02769	Medicaid	MN	-
616822100	Other	MN	MEDICAL ASSISTANCE
88A90BR	Other	MN	BLUE CROSS BLUE SHIELD

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

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Great Lakes Oral & Maxillofacial Surgery, P.A.?

Great Lakes Oral & Maxillofacial Surgery, P.A. is registered in NPPES as a Oral and Maxillofacial Surgery (Dentist) (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-10-20.