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Organization

Minnesota Head and Neck Pain Clinic, PA

NPI Record: ActiveDentist — Orofacial Pain
NPI1003316852
Saint Cloud, Minnesota

Provider's NPPES record last updated: July 17, 2024

Overview

Entity Type
Organization
NPI
1003316852
Primary Specialty
Dentist — Orofacial Pain
Practice Location
Saint Cloud, Minnesota
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 17, 2026, 10:45 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Dentist

    Orofacial Pain

    Dental Providers

    Primary

    A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.

    Taxonomy code 1223X2210X
  • Specialist

    Other Service Providers

    An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

    Taxonomy code 174400000X

Practice Locations

Practice Location

622 Roosevelt Rd

Saint Cloud, Minnesota 56301-6153

Phone: (763) 577-2484

Other Names

  • Minnesota Head & Neck Pain ClinicReported July 17, 2024
  • Minnesota Head & Neck Pain ClinicReported October 16, 2023

Record Information

Enumeration Date
February 19, 2018
Provider's NPPES Record Last Updated
July 17, 2024
Certification Date
October 16, 2023
NPISignal NPPES Dataset
August 2026

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