Individual provider Active NPI

Timothy Paul Mininger II, D.D.S.

  • General Practice Dentistry
  • Westerville, OH
National Provider Identifier
1114157187
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023216 Issued in OH
Practice address
6473 N Hamilton Rd
Westerville, OH 43081-7157
Phone
(614) 517-3565
NPI assigned
Jul 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028059 IL
General Practice Dentistry 1223G0001X 30-023216 OH Primary

Addresses

Primary practice location

6473 N Hamilton Rd
Westerville, OH 43081-7157

Mailing address

6473 N Hamilton Rd
Westerville, OH 43081-7157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160531000030 TX Order and Referring Only - DentistPractitioner - Dentist 5092005355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019028059ILMDDentist
30-023216OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1114157187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 N HAMILTON RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430817157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6473 N HAMILTON RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430817157",
            "telephone_number": "614-517-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MININGER",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028059",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.