Michael John Mintz, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12009136 Issued in IN

Practice address

934 Richard Rd
Dyer, IN 46311-1936

Phone

(219) 865-9790

Fax

(219) 865-9792

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illiana Endodontics, P.C.

  • Endodontics
  • Dyer, IN
  • NPI 1912070228
  NPD Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598848715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "219-865-9790",
            "fax_number": "219-865-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111936",
            "telephone_number": "219-865-9790",
            "fax_number": "219-865-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12009136",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Neurology Associates PC
• Mercedies Mikler, PHARMD
• Albert F. Milford III, D.O.
• Katrina A Miller, LCSW
• Mindful Connections, LLP
• Valerie Mitchell
• MN Imaging Center
• MN Imaging LLC
• Mobile Therapy Partners, LLC
• Humaira Mohiuddin, RD

• Endodontics in Dyer, IN
• Providers in Dyer, IN by specialty
• Endodontics in Indiana

• 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.