Audrey Min

Primary specialty

DentistTaxonomy code 122300000X

License

106684 Issued in CA

Practice address

680 Bancroft Ave
San Leandro, CA 94577-2904

Phone

(510) 569-0218

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Mike Chang DDS Inc

  • Dentist
  • San Leandro, CA
  • NPI 1881933190
  NPD
• Bancroft Dental Care

  • Dentist
  • San Leandro, CA
  • NPI 1659725240
  NPD (past)

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1043970957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 SHORELINE DR APT 206",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015991",
            "telephone_number": "213-330-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BANCROFT AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772904",
            "telephone_number": "510-569-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "AUDREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamryn E Miller
• Iyanna Mills
• Leslie Mills
• Kesa Milts
• Lanita Lanette Mims
• Byoung Wook Min, L.AC.
• Yoojung Min, DDS
• Mackenzie Ilene Minard
• Minati Desai Acharya, O.D., Optometric Corporation
• Minati Desai Acharya, O.D., Optometric Corporation

• Dentist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.