Individual provider Active NPI

Mina Dinh, DDS

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1467929240
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS041965 Issued in PA
Practice address
850 N 11TH St
Philadelphia, PA 19123-1957
Phone
(215) 769-1100
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS041965 PA Primary

Addresses

Primary practice location

850 N 11TH St
Philadelphia, PA 19123-1957

Mailing address

3303 N 16TH St Apt 2
Philadelphia, PA 19140-4902
Phone (714) 642-4624

Other practice location 1

4700 Wissahickon Ave Ste 119
Philadelphia, PA 19144-4248
Phone (215) 843-9720

Other practice location 2

6120-B Woodland Ave
2nd Floor
Philadelphia, PA 19142
Phone (215) 727-4721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816001903 PA Practitioner - Dentist 0042615957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS041965PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice & Counseling Services Network, Inc. CurrentSince May 11, 2021 Accepting new patients
Resources for Human Development, Inc. CurrentSince May 11, 2021 Accepting new patients
Family Practice & Counseling Services Network, Inc. Past Accepting new patients
Resources for Human Development, Inc. Past Accepting new patients

Locations

850 N 11th St
Philadelphia, PA 19123
Phone (215) 685-2684

6120 Woodland Ave
Fl 2
Philadelphia, PA 19142
Phone (215) 727-4721

4700 Wissahickon Ave
Ste 119
Philadelphia, PA 19144
Phone 2158439720 ext. 3640

4700 Wissahickon Ave
Ste 118
Philadelphia, PA 19144
Phone 26759736006771

2300 W Master St
Philadelphia, PA 19121
Phone (267) 687-1172

4700 Wissahickon Ave
Bldg D
Philadelphia, PA 19144
Phone (215) 843-9720

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1467929240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 N 16TH ST APT 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404902",
            "telephone_number": "714-642-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231957",
            "telephone_number": "215-769-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Wissahickon Ave Ste 119",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191444248",
            "country_code": "US",
            "telephone_number": "215-843-9720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6120-B Woodland Ave",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19142",
            "country_code": "US",
            "telephone_number": "215-727-4721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINH",
        "first_name": "MINA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.