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

Northern Star Oral and Maxillofacial Surgery PLLC

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1699901140

Northern Star Oral and Maxillofacial Surgery PLLC is an Oral and Maxillofacial Surgery Clinic/Center in St Louis Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2009.

Licensed in
MN
In the registry since
2009
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5100 Gamble Dr Ste 125
St Louis Park, MN 55416-1585
Phone: (952) 465-0105
Fax: (952) 465-0106
Show map & directions

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

Specialties & licences

Oral and Maxillofacial Surgery Clinic/Center (primary) Taxonomy 261QS0112X · Licence D11399 (MN)

Record details

NPI number1699901140
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Julie Chavez — Owner · (952) 465-0105
NPI enumeratedJune 10, 2009
Last updated in NPPESJune 23, 2014
Mailing address5100 Gamble Dr, Suite 125, St Louis Park, MN 55416-1585