Magdalena B Minkowicz
Individual provider Active NPI General Practice Dentistry · Santa Ana, CA
NPI 1568014686 · NPPES record last updated Oct 19, 2020
Key facts
- NPI
- 1568014686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DDS104547 (CA)
- Practice address
- 2800 N Main St Unit 1010
Santa Ana, CA 92705-6608 - Phone
- (714) 617-7979
- NPI assigned
- Jul 9, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS104547 | CA | MD | General Practice Dentistry |
| 019.032110 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen W. Clark, DDS Inc. | General Practice | Past |
Accepting new patients |
| Acevedo Dental Office, Inc. | General Practice | Past |
Accepting new patients |
| Brock Lorenz Dental Corporation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS104547 | CA | Yes |
| General Practice Dentistry | 1223G0001X | 019.032110 | IL |
Addresses
Primary practice location
2800 N Main St Unit 1010
Santa Ana, CA 92705-6608
Mailing address
113 Gitano
Irvine, CA 92618-1115
Phone (917) 767-4749
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- Betty Minehan
- Minh Canh DO, MD, Inc.
- Roxana P Minkus
- April Minn
- Marianne Ethel Minor
- Ashley Minus
- Sue Mir
All providers in Santa Ana, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.