Individual provider Active NPI

Zainah M Shaker, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Blaine, MN
National Provider Identifier
1083007744
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D13530 Issued in MN
Practice address
1351 113TH Ave NE Ste 400B
Blaine, MN 55434-3874
Phone
(763) 415-1222
NPI assigned
Mar 5, 2015
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.034271 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6002286-15 WI
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D13530 MN Primary

Addresses

Primary practice location

1351 113TH Ave NE Ste 400B
Blaine, MN 55434-3874

Mailing address

1351 113TH Ave NE Ste 400B
Blaine, MN 55434-3874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825002468 MN Practitioner - Oral Surgery 2163717471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.034271ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. General Practice CurrentSince Nov 27, 2017 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. General Practice CurrentSince Nov 27, 2017 Accepting new patients
All Kids Dental Center, LLC General Practice PastSince Jan 14, 2024 Accepting new patients
Twin Anesthesia LLC PastSince Nov 10, 2024 Accepting new patients

Locations

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1083007744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 113TH AVE NE STE 400B",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 113TH AVE NE STE 400B",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343874",
            "telephone_number": "763-415-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKER",
        "first_name": "ZAINAH",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034271",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6002286-15",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D13530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.