Individual provider Active NPI

Patricia A Rake, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Minneapolis, MN
National Provider Identifier
1730255134
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11142 Issued in MN
Practice address
515 Delaware St SE
7-174 Moos Tower
Minneapolis, MN 55455-0357
Phone
(612) 624-8600
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11142 MN Primary

Addresses

Primary practice location

515 Delaware St SE
7-174 Moos Tower
Minneapolis, MN 55455-0357

Mailing address

515 Delaware St SE
Oral Surgery 7TH Floor Moos Tower
Minneapolis, MN 55455-0357

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
I20070723000570 MN Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 5496856338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
University of Minnesota School of Dentistry, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Dakota Valley Oral and Maxillofacial Surgery PLLCGroup PAC ID 9436127560, 6 clinicians

Practice addresses (Care Compare)

2130 Cliff Rd
Suite 100
Eagan, MN 55122-2486
Phone (651) 452-6933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Oral and Maxillofacial Surgery CurrentSince Jan 1, 2014 Accepting new patients
Regents of the University of Minnesota CurrentSince Jan 1, 2014 Accepting new patients
Dakota Valley Oral and Maxillofacial Surgery, PLLC Oral and Maxillofacial Surgery CurrentSince Sep 1, 2002 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients

Locations

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

2130 Cliff Rd
Ste 100
Saint Paul, MN 55122
Phone (651) 452-6933

Organizations & group practices 4

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1730255134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "ORAL SURGERY 7TH FLOOR MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "7-174 MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-624-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "11142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.