Regents of the University of Minnesota

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

24D0973260 Issued in MN

Legal business name

REGENTS OF THE UNIVERSITY OF MINNESOTA

Doing business as

University Oral Pathology Laboratory

Practice address

515 Delaware St SE
16-116 Moos Tower
Minneapolis, MN 55455-0357

Phone

(612) 624-5478

Fax

(612) 626-3076

NPI assigned

Nov 9, 2006

Last updated

Jun 14, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

REGENTS OF THE UNIVERSITY OF MINNESOTAAs reported in NPPES

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

Authorized official

Name

Dr. Keith Mays, DDS, MS, PHD

Title

Dean, Uofmn School of Dentistry

Phone

(612) 624-2424

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• University Oral Pathology Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Regents of Univ of MN S

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajaram Gopalakrishnan, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Minneapolis, MN
  • NPI 1134230022
  NPD
• Shanti Kaimal, BDS, MDS

  • Dentist
  • Minneapolis, MN
  • NPI 1124385018
  NPD
• Ioannis Koutlas, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Minneapolis, MN
  • NPI 1447361332
  NPD
• Stephanie L Wetzel, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Alpharetta, GA
  • NPI 1528217940
  NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1962572784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 83",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-624-5478",
            "fax_number": "612-626-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "address_2": "16-116 MOOS TOWER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-624-5478",
            "fax_number": "612-626-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MINNESOTA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF MINNESOTA",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "MAYS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "DEAN, UOFMN SCHOOL OF DENTISTRY",
        "authorized_official_telephone_number": "612-624-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS, PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MN",
            "license": "24D0973260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325413500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Oral Pathology Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regents of the University of Minnesota (Oral Medicine and Diagnosis Clinic)
• Regents of the University of Minnesota (Boynton Health Service)
• Regents of the University of Minnesota (TMD and Orofacial Pain Clinic)
• Regents of the University of Minnesota (U of MN School of Dentistry)
• Regents of the University of Minnesota (Cleft Palate Craniofacial Anomalies Clinics)
• Regents of the University of Minnesota (U of MN Faculty Practice Orthodontics)
• Regents of the University of Minnesota (Oral Pathology Clinic)
• Kimberlee Jean Reger, PT
• Regional Physician Services of Minnesota PC (Matrix Medical Network)
• Regional Service Inc

• Clinical Medical Laboratory in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Medical Laboratory in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.