Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bloomington Oral & Maxillofacial Surgery Group

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1386762318

Bloomington Oral & Maxillofacial Surgery Group is an Oral & Maxillofacial Surgery (D.M.D.) in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2007.

Licensed in
IN
In the registry since
2007

Practice location Address checks out

637 S Walker St Ste 1
Bloomington, IN 47403-2154
Phone: (812) 323-9700
Fax: (812) 323-9701
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence IN12010196A (IN)

Record details

NPI number1386762318
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Tate — Doctor President · (812) 323-9700
NPI enumeratedMarch 27, 2007
Last updated in NPPESAugust 22, 2020
Mailing address637 S Walker Street, Suite 1, Bloomington, IN 47403-2154