Individual provider Active NPI

Asif Rahman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • St Paul, MN
National Provider Identifier
1841398914
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11315 Issued in MN
Practice address
2500 Como Ave
St Paul, MN 55108
Phone
(651) 999-4600
Fax
(651) 632-8984
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 11315 MN Primary

Addresses

Primary practice location

2500 Como Ave
St Paul, MN 55108

Mailing address

Mail Code 21113a
PO Box 1309
Minneapolis, MN 55440-1309
Phone (952) 883-5151

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080221000604 MN Practitioner - Oral Surgery 1355425851 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11315MNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Nov 17, 2010 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. Oral and Maxillofacial Surgery CurrentSince Nov 17, 2010 Accepting new patients

Locations

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841398914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAIL CODE 21113A",
            "address_2": "PO BOX 1309",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "952-883-5151",
            "fax_number": "952-883-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55108",
            "telephone_number": "651-999-4600",
            "fax_number": "651-632-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "ASIF",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "11315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

Verify at the official NPI Registry.