Jeffrey Tylon Mintz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5832 Issued in NC

Practice address

988 Ocean Hwy W
Supply, NC 28462-4060

Phone

(910) 754-7850

Fax

(910) 755-6334

NPI assigned

Jun 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John Romulus DDS PLLC

  • General Practice Dentistry
  • Supply, NC
  • NPI 1043872047
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700814563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 329",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284620329",
            "telephone_number": "910-754-7850",
            "fax_number": "910-755-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OCEAN HWY W",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624060",
            "telephone_number": "910-754-7850",
            "fax_number": "910-755-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTZ",
        "first_name": "JEFFREY",
        "middle_name": "TYLON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "96001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antran T McDaniel, PTA
• Brian James McKlindon, DNP, FNP-C
• Corie M McRanie, D.D.S
• Heather Merrow, PAC
• Lauren Dexter Miller, AUD
• Moving Ahead Counseling Services
• Crystal Dawn Murphy, C-PNP
• New Life Sleep Consultants Inc.
• Eunika Nichole Norman, LCSWA
• North Carolina Physician Network, Inc. (Brunswick Women's Center)

• General Practice Dentistry in Supply, NC
• Providers in Supply, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.