Mint Dental Care PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MINT DENTAL CARE PLLC

Practice address

1415 Fillmore St Ste 701
Twin Falls, ID 83301-3346

Phone

(208) 735-1415

NPI assigned

Aug 29, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Chase Alan Funk, DDSNPI 1962816025

Title

Owner

Phone

(208) 735-1415

Specialties & licenses 1

Addresses

Other names 1

• Mint Dental Care Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chase A Funk, DDS

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1962816025
  NPD Authorized official
• Kevin Lavar Hamblin, DDS

  • Dentist
  • Twin Falls, ID
  • NPI 1750589594
  NPD (past)
• Mark C Lambert, DMD

  • General Practice Dentistry
  • Twin Falls, ID
  • NPI 1902918402
  NPD (past)
• Don S Wyatt, DDS

  • General Practice Dentistry
  • Jerome, ID
  • NPI 1841494119
  NPD (past)

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1245064427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 FILLMORE ST STE 701",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013346",
            "telephone_number": "208-735-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 FILLMORE ST STE 701",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013346",
            "telephone_number": "208-735-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "CHASE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-735-1415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mint Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael S Milligan, LCSW
• Julie Mills
• Kimberly Miloser, MS, CCC-SLP
• Carla Sue Mingo, MS CCC-SLP
• Michael Chase Mings
• Ravae Minton, MSW, LCSW
• Miranda Medical, PLLC
• A. Richard Miranda, MD
• Cortney R Mitchell, AUD,BS,AA
• Rosemary L Mitchell, LMSW

• General Practice Dentistry in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.