Individual provider Active NPI

Shanti Kaimal, BDS, MDS

  • Dentist
  • Minneapolis, MN
National Provider Identifier
1124385018
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
FL37 Issued in MN
Practice address
515 Delaware St SE
6-320 Moos Tower
Minneapolis, MN 55455-0357
Phone
(612) 625-2140
Fax
(612) 626-0138
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X FL37 MN Primary

Addresses

Primary practice location

515 Delaware St SE
6-320 Moos Tower
Minneapolis, MN 55455-0357

Mailing address

515 Delaware St SE
6-320 Moos Tower
Minneapolis, MN 55455-0357
Phone (612) 625-2140

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000949 MN Practitioner - Oral SurgeryPractitioner - Pain Management 0749446730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Pain Management
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 Delaware St SE
07 530 Moos Health Science Tower
Minneapolis, MN 55455-0357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL37MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Apr 30, 2017 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Physicians CurrentSince Feb 1, 2016 Accepting new patients
Regents of the University of Minnesota CurrentSince Apr 30, 2017 Accepting new patients
University of Minnesota Physicians CurrentSince Feb 1, 2016 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

420 Delaware St SE
Ste MMC83
Minneapolis, MN 55455

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1124385018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "6-320 MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-625-2140",
            "fax_number": "612-626-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "6-320 MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-625-2140",
            "fax_number": "612-626-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIMAL",
        "first_name": "SHANTI",
        "name_prefix": "Dr.",
        "credential": "BDS, MDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "FL37",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.