Michael J. Min, DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50163 Issued in CA

Legal business name

MICHAEL J. MIN, DDS INC

Practice address

1921 E 4TH St
Ontario, CA 91764-2603

Phone

(909) 989-1556

Fax

(909) 989-3132

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Michael Min, D.M.D.

Title

President

Phone

(909) 989-1556

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1245390244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 E 4TH ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 E 4TH ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642603",
            "telephone_number": "909-989-1556",
            "fax_number": "909-989-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. MIN, DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "MIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-989-1556",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.