Mint Oral Surgery, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MINT ORAL SURGERY, PLLC

Practice address

2805 E Grapevine Mills Cir Ste 180
Grapevine, TX 76051-1214

Phone

(214) 821-6468

NPI assigned

Dec 18, 2017

Last updated

Dec 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carly Lothman

Title

Regional Director

Phone

(214) 821-6468

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1033625736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 N CENTRAL EXPY UNIT 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752060949",
            "telephone_number": "214-821-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 E GRAPEVINE MILLS CIR STE 180",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760511214",
            "telephone_number": "214-821-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT ORAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "LOTHMAN",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "214-821-6468"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Above Matter LLC
• Mind Above Matter, LLC
• Mindful Path Counseling & Wellness PLLC
• Leslie Jean Miner, D.C.
• Mint Dentistry, PLLC (Grapevine Mint Dentistry)
• Shazia Mirza
• Kelly Mitchell, P.T.
• Monalisa M Mitra, DO
• Caitlyn Hazzard Mixon
• Mobility Care

• Dental Clinic/Center in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.