Individual provider Active NPI

Aye Min, DMD MSD

  • Dentist
  • Vacaville, CA
National Provider Identifier
1649304205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39587 Issued in CA
Practice address
2611 Nut Tree Rd
Suite #D
Vacaville, CA 95687
Phone
(707) 449-8808
Fax
(707) 449-6303
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39587 CA Primary

Addresses

Primary practice location

2611 Nut Tree Rd
Suite #D
Vacaville, CA 95687

Mailing address

2611 Nut Tree Rd
Suite #D
Vacaville, CA 95687
Phone (707) 449-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240209000970 CA Practitioner - DentistPractitioner - Endodontics 1759724438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39587CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Jan 29, 2024 Accepting new patients
Alameda Health System CurrentSince Jan 29, 2024 Accepting new patients
Mu Mu Min DMD MSD Inc Dentist Past Accepting new patients

Locations

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

Interoperability endpoints

  • Direct secure messaging: amin114780@alamedahs.direct-ci.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649304205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 NUT TREE RD",
            "address_2": "SUITE #D",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-449-8808",
            "fax_number": "707-449-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 NUT TREE RD",
            "address_2": "SUITE #D",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-449-8808",
            "fax_number": "707-449-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "AYE",
        "name_prefix": "Dr.",
        "credential": "DMD MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.