Grant E Raykowski, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12004 Issued in MN

Practice address

410 Church St SE
Minneapolis, MN 55455-0222

Phone

(612) 625-5430

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Regents of the University of Minnesota

  • Student Health Clinic/Center
  • Minneapolis, MN
  • NPI 1013137355
  NPD
• Regents of the University of Minnesota

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  NPD
• Regents of the University of Minnesota

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1245223486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "612-625-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYKOWSKI",
        "first_name": "GRANT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas Jeffrey Ray, MD
• Lucia Ray
• Rayaf Health LLC
• Arpana Rayannavar, MD
• Raye McPhillips Eyrich, PH.D., L.P., LLC
• Raymond W. Scallen, MD PLC
• Colleen Raymond
• Nancy C Raymond, MD
• Joselyn Arciaga Raymundo, PHARM D
• Michelle Rayne, MD, PHARMD

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.