Organization Active NPI

Min Prosthodontics PLLC

Doing business as Blue Dental

  • Dentist
  • New York, NY
National Provider Identifier
1225893860
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MIN PROSTHODONTICS PLLC
Doing business as
Blue Dental
Practice address
360 E 72ND St Ofc C
New York, NY 10021-4753
Phone
(212) 988-1089
Fax
(646) 843-7701
NPI assigned
Feb 13, 2024
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Daniel Min, DDSNPI 1902237449
Title
Owner
Phone
(212) 988-1089

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

360 E 72ND St Ofc C
New York, NY 10021-4753

Mailing address

360 E 72ND St Ofc C
New York, NY 10021-4753

Other names 1

  • Blue Dental Doing business as

National Provider Directory

National Provider Directory

Locations

360 E 72nd St
Frnt 1C
New York, NY 10021

360 E 72nd St
Ofc C
New York, NY 10021
Phone (212) 439-6100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1225893860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E 72ND ST OFC C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E 72ND ST OFC C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214753",
            "telephone_number": "212-988-1089",
            "fax_number": "646-843-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIN PROSTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "MIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-988-1089",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.