Derrick Tint MD, Corporation

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

DERRICK TINT MD, CORPORATION

Practice address

341 Magnolia Ave Ste 206
Corona, CA 92879-3332

Phone

(951) 735-0470

NPI assigned

Jan 6, 2021

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Tint, MDNPI 1033554423

Title

Owner

Phone

(949) 246-3072

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derrick Tint, M.D.

  • Otolaryngology Physician
  • Murrieta, CA
  • NPI 1033554423
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1659969590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 206",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-735-0470",
            "fax_number": "951-735-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 206",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-735-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK TINT MD, CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "TINT",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-246-3072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A160407",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1033554423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD463754",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dentists at Lakeside, Prof. Corp. (Dentists at Lakeside)
• Brittney Depue
• Sared Deras
• Derek Q Phan MD Medical Corporation
• Dermatology Research and Education Foundation (California Dermatology)
• Levi Derting
• Anjali Pinak Desai, A.P, LAC.
• Dhaval Desai, M.D.
• Girish B Desai, D.D.S
• Hikshu H Desai, DDS

• Medical Specialty Clinic/Center in Corona, CA
• Providers in Corona, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.