Individual provider Active NPI

Minh Binh DO, DDS

  • Dentist
  • Boutte, LA
National Provider Identifier
1235706797
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7239 Issued in LA
Practice address
14243 Highway 90
Boutte, LA 70039-3517
Phone
(985) 758-5110
NPI assigned
Jun 4, 2021
Last updated
Jun 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7239 LA Primary

Addresses

Primary practice location

14243 Highway 90
Boutte, LA 70039-3517

Mailing address

1220 Barbe Dr
Westwego, LA 70094-5462
Phone (504) 458-7493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210712001832 LA Order and Referring Only - DentistPractitioner - Dentist 6800298944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7239LAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1235706797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 BARBE DR",
            "city": "WESTWEGO",
            "state": "LA",
            "postal_code": "700945462",
            "telephone_number": "504-458-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14243 HIGHWAY 90",
            "city": "BOUTTE",
            "state": "LA",
            "postal_code": "700393517",
            "telephone_number": "985-758-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "MINH",
        "middle_name": "BINH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boutte, LA

Sources for this page

Verify at the official NPI Registry.