Olivia Min, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

109494 Issued in CA

Practice address

2233 E Garvey Ave N Ste a
West Covina, CA 91791-1500

Phone

(626) 605-6201

NPI assigned

Aug 24, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 5, 2017 through Apr 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1659826147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 PARK DR UNIT 9306",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917094958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 E GARVEY AVE N STE A",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500",
            "telephone_number": "626-605-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "OLIVIA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "109494",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikkon Adult Day Health Care Center
• Laura Dru Miles, LICENSED MARRIAGE AN
• Jenna Milhon
• Crystal Rose Miller
• Joe Michael Miller
• Aaron Miranda
• Cesar Miranda
• Daniel Raul Miranda Jr., PTA
• Krystel Dyann Miranda
• Mirhamid Salek, DDS, Professional Corporation

• Pediatric Dentistry in West Covina, CA
• Providers in West Covina, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.