John E Minalt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-021250 Issued in IL

Practice address

200 W Front St Ste 90
Harvard, IL 60033-2709

Phone

(815) 236-8694

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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 Jan 11, 2016 through Jan 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Minalt & Wojcicki Dental Group LLC

  • Dentist
  • Bloomingdale, IL
  • NPI 1144579905
  NPD (past) Authorized official
• Bloomingdale Dental Rez, PC

  • Dentist
  • Bloomingdale, IL
  • NPI 1043750714
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1669567491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W FRONT ST STE 90",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600332709",
            "telephone_number": "815-236-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W FRONT ST STE 90",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600332709",
            "telephone_number": "815-236-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINALT",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6204-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-021250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Harvard Hospital Inc
• Mercy Harvard Hospital Inc
• Mercy Health System Corporation
• Mercy Health System Corporation
• Michael J. Krol D.D.S. P.C.
• Eric Vincent T Miranda, PT
• Michele K Moore, OT
• Morgen M Kaiser DDS PC
• Thy Nguyen, PHARMD
• Northwest Rescue LLC

• General Practice Dentistry in Harvard, IL
• Providers in Harvard, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.