Mint Dental Shakopee PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MINT DENTAL SHAKOPEE PLLC

Practice address

205 Lewis St S Ste 101
Shakopee, MN 55379-2290

Phone

(952) 445-3349

NPI assigned

Oct 4, 2018

Last updated

Oct 4, 2018By 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. Marwa Gamam-Forest, DDS

Title

Dentist

Phone

(952) 831-1332

Specialties & licenses 1

Addresses

Locations

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.

• Matthew Gregory Borowicz, DDS

  • Dentist
  • Bloomington, MN
  • NPI 1154989770
  NPD (past)

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1689149775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LEWIS ST S STE 101",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792290",
            "telephone_number": "952-445-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 LEWIS ST S STE 101",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792290",
            "telephone_number": "952-445-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT DENTAL SHAKOPEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "GAMAM-FOREST",
        "authorized_official_first_name": "MARWA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "952-831-1332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerrald C Miller, D.C.
• Linda Louise Miller, MA LP
• Andy Jonathan Minemann
• Minneapolis Vamc
• Minnesota Dental Professionals, P.C. (Riverside Valley Dental Care)
• Alexander David Miranda
• Tatyana Mishkin Gleyzer, CNP
• Mission Chiropractic & Acupuncture PLLC
• Kasie Jean Mix, O.D., M.S.
• Asma Mohamed I

• Dental Clinic/Center in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.