Individual provider Active NPI

Mindy Knox, DDS

  • Dentist
  • Medford, OR
National Provider Identifier
1518344589
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11019 Issued in OR
Practice address
1113 Progress Dr
Medford, OR 97504-5201
Phone
(541) 512-3900
NPI assigned
Apr 29, 2015
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11019 OR Primary

Addresses

Primary practice location

1113 Progress Dr
Medford, OR 97504-5201

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other practice location 1

277 5th St
Ashland, OR 97520-2058
Phone (541) 482-1744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190613001812 OR Order and Referring Only - DentistPractitioner - Dentist 5193058774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Kitchell Dentist Past Accepting new patients
Dr. Daniel Dewey Jackson DDS Past Accepting new patients
La Clinica del Valle Family Health Care Center Inc. PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1518344589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 PROGRESS DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045201",
            "telephone_number": "541-512-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 5th St",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "OR",
            "postal_code": "975202058",
            "country_code": "US",
            "telephone_number": "541-482-1744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOX",
        "first_name": "MINDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.