James S Minutello

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

035298 Issued in CA

Practice address

770 Magnolia Ave Suite 2-E
Corona, CA 92879-3122

Phone

(951) 279-7847

Fax

(951) 279-7422

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. James Minutello Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457564296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16574 BRIGHTRIDGE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925039702",
            "telephone_number": "951-359-1472",
            "fax_number": "951-279-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MAGNOLIA AVE SUITE 2-E",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793122",
            "telephone_number": "951-279-7847",
            "fax_number": "951-279-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINUTELLO",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "035298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "MINUTELLO",
            "prefix": "MR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Periodontics in Corona, CA
• Providers in Corona, CA by specialty
• Periodontics in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.