Mint Dental Independence, LLC.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MINT DENTAL INDEPENDENCE, LLC.

Practice address

514 S Noland Rd Ste 120
Independence, MO 64050-3973

Phone

(816) 836-5520

NPI assigned

Aug 10, 2022

Organization subpart

No

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

Authorized official

Name

Wayne Dobbins, DDS

Title

Ceo

Phone

(480) 343-5072

Specialties & licenses 1

Addresses

Other names 1

• Mint Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Eugene Jennings, DDS

  • General Practice Dentistry
  • Independence, MO
  • NPI 1831284801
  NPD (past)

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1609504471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 W 65TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662179342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S NOLAND RD STE 120",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503973",
            "telephone_number": "816-836-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT DENTAL INDEPENDENCE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "DOBBINS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-343-5072",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mint Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zoe K Miller, MS, PLMFT
• Erin Michele Mills, O.D.
• Kara Mills
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• Jillian Rose Miranda, RD, LD
• Missouri Caris Healthcare LLC
• Missouri CVS Pharmacy LLC

• Dental Clinic/Center in Independence, MO
• Providers in Independence, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.