Individual provider Active NPI

Dena M. Mintz, O.D.

  • Optometrist
  • Corona, CA
National Provider Identifier
1205911377
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT8810TPA Issued in CA
Practice address
800 Magnolia Ave Ste 113
Corona, CA 92879-3123
Phone
(951) 737-7820
Fax
(951) 737-7844
NPI assigned
Oct 26, 2006
Last updated
Sep 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT8810TPA CA Primary

Addresses

Primary practice location

800 Magnolia Ave Ste 113
Corona, CA 92879-3123

Mailing address

800 Magnolia Ave Ste 113
Corona, CA 92879-3123
Phone (951) 737-7820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT8810TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Arabi O.D., Inc Optometrist CurrentSince Apr 23, 2016 Accepting new patients
Mintz Family Optometry, Apc Optometrist PastSince Jun 25, 2010 Accepting new patients

Locations

800 Magnolia Ave
Ste 113
Corona, CA 92879
Phone (951) 520-9392

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1205911377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAGNOLIA AVE STE 113",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793123",
            "telephone_number": "951-737-7820",
            "fax_number": "951-737-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAGNOLIA AVE STE 113",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793123",
            "telephone_number": "951-737-7820",
            "fax_number": "951-737-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "DENA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8810TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.