Individual provider Active NPI

Saharla A Jama, DMD

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1912003203
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12126 Issued in MN
Practice address
2228 E Lake St
Minneapolis, MN 55407-4321
Phone
(612) 886-3270
Fax
(612) 677-3330
NPI assigned
Sep 15, 2006
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12126 MN Primary

Addresses

Primary practice location

2228 E Lake St
Minneapolis, MN 55407-4321

Mailing address

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

Other practice location 1

450 N Syndicate St
#300
Saint Paul, MN 55104
Phone (651) 254-7373

Other practice location 2

450 N Syndicate St
#300
Saint Paul, MN 55104
Phone (651) 254-7373

Other identifiers 1

IdentifierTypeStateIssuer
602689300MedicaidMN

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
I20070129000296 MN Practitioner - Oral Surgery 5092716407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12126MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. General Practice CurrentSince May 1, 2015 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. General Practice CurrentSince May 1, 2015 Accepting new patients
Twincare Dental LLC General Practice PastSince Dec 15, 2019 Accepting new patients

Locations

5625 Cenex Dr
Inver Grove Heights, MN 55077
Phone (651) 552-2600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

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

450 Syndicate St N
Ste 300
Saint Paul, MN 55104
Phone (651) 254-7373

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1912003203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MAIL CODE 21113A",
            "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": "2228 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074321",
            "telephone_number": "612-886-3270",
            "fax_number": "612-677-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 N Syndicate St",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55104",
            "country_code": "US",
            "telephone_number": "651-254-7373",
            "fax_number": "651-254-7383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 N Syndicate St",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55104",
            "country_code": "US",
            "telephone_number": "651-254-7373",
            "fax_number": "651-254-7383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMA",
        "first_name": "SAHARLA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "12126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602689300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.