NPIMap

Organization Active NPI

Ilien Jimeniz Minter DDS Inc

  • General Practice Dentistry
  • Poway, CA
National Provider Identifier
1689740102
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DUO34933 Issued in CA
Legal business name
ILIEN JIMENIZ MINTER DDS INC
Practice address
15725 Pomerado Rd
Ste 204
Poway, CA 92064
Phone
(858) 485-8420
Fax
(858) 485-5773
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Ilien J Minter, DDS
Title
Owner
Phone
(858) 485-8420

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 51974 CA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DUO34933 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 38912 CA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 55919 CA

Addresses

Primary practice location

15725 Pomerado Rd
Ste 204
Poway, CA 92064

Mailing address

15725 Pomerado Rd
Ste 204
Poway, CA 92064
Phone (858) 485-8420

Other names 1

  • Gateway Dental Gateway Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

15725 Pomerado Rd
Ste 204
Poway, CA 92064
Phone (858) 485-8420

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1689740102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD",
            "address_2": "STE 204",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-485-8420",
            "fax_number": "858-485-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD",
            "address_2": "STE 204",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-485-8420",
            "fax_number": "858-485-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILIEN JIMENIZ MINTER DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MINTER",
        "authorized_official_first_name": "ILIEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-485-8420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51974",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DUO34933",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38912",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Dental Gateway Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.