Active NPI
Minnie Koo, DMD
- Dentist
- Mansfield, TX
National Provider Identifier
1225758253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38916
- Practice address
- 287 Frontage Rd Suite 160
Mansfield, TX 76063 - Phone
- (817) 405-2260
- NPI assigned
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 38916 | TX | Primary |
Addresses
Primary practice location
287 Frontage Rd Suite 160
Mansfield, TX 76063
Mailing address
3100 Joplin Rd Apt 2207
Kennedale, TX 76060-6249
Phone (702) 376-7358
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38916 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1225758253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 JOPLIN RD APT 2207",
"city": "KENNEDALE",
"state": "TX",
"postal_code": "760606249",
"telephone_number": "702-376-7358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 FRONTAGE RD SUITE 160",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "76063",
"telephone_number": "817-405-2260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOO",
"first_name": "MINNIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-30",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "38916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.