Individual provider Active NPI

Renie Daniel, MD, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Minneapolis, MN
National Provider Identifier
1265620504
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
22DI02345200 Issued in NJ
Practice address
515 Delaware St SE
Moos Tower 7-174D
Minneapolis, MN 55455-4220
Phone
(612) 301-2233
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2017-00626 NC
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 22DI02345200 NJ Primary

Addresses

Primary practice location

515 Delaware St SE
Moos Tower 7-174D
Minneapolis, MN 55455-4220

Mailing address

515 Delaware St SE
Moos Tower 7-174D
Minneapolis, MN 55455
Phone (612) 301-2233

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
I20240418000183 MN Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 5496061921

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
New York Medical College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 Delaware St SE
Minneapolis, MN 55455-0357

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22DI02345200NJMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Mar 1, 2024 Accepting new patients
Regents of the University of Minnesota CurrentSince Mar 1, 2024 Accepting new patients
Regents of the University of Minnesota Oral and Maxillofacial Surgery PastSince Jun 30, 2024 Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: rdaniel233684@direct.unc.nchie.net
  • Direct secure messaging: rdaniel907202@fairview.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1265620504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "MOOS TOWER 7-174D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-301-2233",
            "fax_number": "612-624-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "MOOS TOWER 7-174D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554220",
            "telephone_number": "612-301-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "RENIE",
        "name_prefix": "Dr.",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "2017-00626",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02345200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.