Individual provider Active NPI

Jason Abram Minton, DMD

  • General Practice Dentistry
  • Greenville, SC
National Provider Identifier
1033409784
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7043 Issued in SC
Practice address
110 Villa Rd
Greenville, SC 29615-3010
Phone
(864) 282-1925
NPI assigned
Apr 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7043 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

110 Villa Rd
Greenville, SC 29615-3010

Mailing address

110 Villa Rd
Greenville, SC 29615-3010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150516000165 SC Order and Referring Only - DentistPractitioner - Dentist 4587984497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7043SCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1033409784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VILLA RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VILLA RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153010",
            "telephone_number": "864-282-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTON",
        "first_name": "JASON",
        "middle_name": "ABRAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "7043",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.