Mint Dental Care LTD

Primary specialty

DentistTaxonomy code 122300000X

License

019025067 Issued in IL

Legal business name

MINT DENTAL CARE LTD

Practice address

4635 W 63Rd St
Ste D
Chicago, IL 60629-5559

Phone

(872) 254-1008

Fax

(847) 665-0416

NPI assigned

Apr 7, 2017

Organization subpart

No

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

Authorized official

Name

Hui Jun Park

Title

President

Phone

(872) 254-1008

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1306379185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 W 63RD ST",
            "address_2": "STE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295559",
            "telephone_number": "872-254-1008",
            "fax_number": "847-665-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 W 63RD ST",
            "address_2": "STE D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295559",
            "telephone_number": "872-254-1008",
            "fax_number": "847-665-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT DENTAL CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HUI JUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "872-254-1008"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deneen Minor
• George G Minor, LPC
• Miata Lanae Minor
• Penelope Minor
• Reese Minshew, PHD
• Jessica Lynne Minton, PT
• Minty Dental Boutique
• Ari David Mintz, M.D.
• David Anthony Mintz, MD
• Judith Wood Mintz, MSW

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.