MAXILLOFACIAL IMAGING LLC NPI 1679732119

NPI Information

  • NPI: 1679732119
  • Provider Name: MAXILLOFACIAL IMAGING LLC
  • Classification: Clinic/Center - 261QR0200X
  • Specialization: Radiology
  • Entity Type: Organization
  • Doing Business As: ADVANCED HEAD & NECK IMAGING
  • Address: 13998 MAPLE KNOLL WAY
    MAPLE GROVE PROFESSIONAL BLD SUITE LL105
    MAPLE GROVE, MN
    ZIP 55369
  • Phone: (763) 420-0070

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NPI Details

MAXILLOFACIAL IMAGING LLC is a radiology clinic center in Maple Grove, MN. MAXILLOFACIAL IMAGING LLC NPI is 1679732119. The provider is registered as an organization entity type.
The provider Is Doing Business As Advanced Head & Neck Imaging.

The provider's business location address is:

13998 MAPLE KNOLL WAY
MAPLE GROVE PROFESSIONAL BLD SUITE LL105
MAPLE GROVE, MN
ZIP 55369-004
Phone: (763) 420-0070

The provider's authorized official is Jane Roach .
The authorized official title is Manager and has the following contact phone number (763) 420-0070.

The enumeration date for this NPI number is 6/9/2008 and was last updated on 6/9/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0200XClinic/CenterRadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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