Saroosh Razi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12772 Issued in MN

Practice address

11 Saint Olaf Ave S
Canby, MN 56220-1463

Phone

(507) 223-7111

NPI assigned

Aug 7, 2007

Last updated

Jul 29, 2016By the provider in NPPES

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

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.

• Sanford Health Network

  dba Sanford Dental Clinic Canby

  • Dental Clinic/Center
  • Canby, MN
  • NPI 1134271703
  NPD (past)

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1295926863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SAINT OLAF AVE S",
            "city": "CANBY",
            "state": "MN",
            "postal_code": "562201463",
            "telephone_number": "507-223-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SAINT OLAF AVE S",
            "city": "CANBY",
            "state": "MN",
            "postal_code": "562201463",
            "telephone_number": "507-223-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZI",
        "first_name": "SAROOSH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Marie McMahon, M.A.
• Casey M Meier
• Peter Brennan Meier, M.D.
• Miranda Jo Ristau Obaniana, DPT
• Mari Petersen, OTR/L
• Rem Southwest Services, Inc.
• Rem Southwest Services, Inc.
• James Darin Ries, OD
• Renae Lynn Ries, OD
• William Rosen, M.D.

• General Practice Dentistry in Canby, MN
• Providers in Canby, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.