Individual provider Active NPI

Ehab Mina, DMD

  • Dentist
  • Norristown, PA
National Provider Identifier
1639515703
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS 030 144L Issued in PA
Practice address
1009 Valley Forge Rd
Norristown, PA 19403-1022
Phone
(610) 630-2373
Fax
(610) 630-5682
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS 030 144L PA Primary

Addresses

Primary practice location

1009 Valley Forge Rd
Norristown, PA 19403-1022

Mailing address

1009 Valley Forge Rd
Norristown, PA 19403-1022
Phone (610) 630-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS 030 144LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1639515703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 VALLEY FORGE RD",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194031022",
            "telephone_number": "610-630-2373",
            "fax_number": "610-630-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 VALLEY FORGE RD",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194031022",
            "telephone_number": "610-630-2373",
            "fax_number": "610-630-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINA",
        "first_name": "EHAB",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS 030 144L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norristown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.