Active NPI
Eric R. Mintalar, D.D.S.
- General Practice Dentistry
- Brooklyn Center, MN
National Provider Identifier
1447396759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D10553
- Practice address
- 3220 County Road 10
Brooklyn Center, MN 55429-3073 - Phone
- (763) 561-6320
- Fax
- (763) 561-6321
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D10553 | MN | Primary |
| General Practice Dentistry | 1223G0001X | 36802 | CA |
Addresses
Primary practice location
3220 County Road 10
Brooklyn Center, MN 55429-3073
Mailing address
3220 County Road 10
Brooklyn Center, MN 55429-3073
Phone (763) 561-6320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10553 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447396759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3220 COUNTY ROAD 10",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554293073",
"telephone_number": "763-561-6320",
"fax_number": "763-561-6321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3220 COUNTY ROAD 10",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554293073",
"telephone_number": "763-561-6320",
"fax_number": "763-561-6321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTALAR",
"first_name": "ERIC",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D10553",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "36802",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn Center, MN
- Mindful Care Living Assisted Living Inc
- Mindful Health and Wellness LLC
- Mindful Health and Wellness LLC
- Mindful Health and Wellness LLC
- Minnesota Dental Professionals, P.C.
- Miracle Living Homecare LLC
- Miriam Home Health Corporation
- Ann Elizabeth Joan Miskovich, MA, LPCC
- Rickyra Mitchell
- MN Best Home Care, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.