Mint Dental Antioch LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MINT DENTAL ANTIOCH LLC

Practice address

8901 W 74TH St Ste 245
Overland Park, KS 66204-2202

Phone

(913) 384-0660

NPI assigned

Aug 10, 2022

Organization subpart

No

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

Authorized official

Name

Wayne Dobbins, DDS

Title

Ceo

Phone

(480) 343-5072

Specialties & licenses 1

Addresses

Other names 1

• Mint Dental Doing business as

Locations

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1427786292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 W 65TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662179342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W 74TH ST STE 245",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042202",
            "telephone_number": "913-384-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT DENTAL ANTIOCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "DOBBINS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-343-5072",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mint Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Dental Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.