Individual provider Active NPI

Monica Minjares, DMD

  • Dentist
  • Port St Lucie, FL
National Provider Identifier
1174602015
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20871 Issued in FL
Practice address
10457 S US Highway 1
Port St Lucie, FL 34952-5645
Phone
(772) 446-4816
Fax
(772) 777-2734
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20871 FL Primary

Addresses

Primary practice location

10457 S US Highway 1
Port St Lucie, FL 34952-5645

Mailing address

10457 S US Highway 1
Port St Lucie, FL 34952-5645
Phone (772) 446-4816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170123000054 FL Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 2062794365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, PC Dentist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1174602015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-446-4816",
            "fax_number": "772-777-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-446-4816",
            "fax_number": "772-777-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINJARES",
        "first_name": "MONICA",
        "name_prefix": "Miss",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.