Dennis Earl Minotti II, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

M5840 Issued in TX

Practice address

230 Miron Dr Ste 110
Southlake, TX 76092-7846

Phone

(817) 416-0970

Fax

(817) 898-0898

NPI assigned

Jul 16, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1417111691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 BRAZOS DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926001",
            "telephone_number": "817-507-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MIRON DR STE 110",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927846",
            "telephone_number": "817-416-0970",
            "fax_number": "817-898-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOTTI",
        "first_name": "DENNIS",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "M5840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Minatrea, PH.D.
• Mind & Med PLLC
• Mindforge Psychiatry, PLLC
• Minerva Labs LLC
• Ameera Sameer Minhas
• Rachel Grace Minyard
• Deborah A. Miscoll, PSY.D.
• Rajeev Misra, D.D.S.
• Audrey Marie Mitchell
• Jessica Mitchell

• Neuromusculoskeletal Medicine & OMM Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.