Organization Active NPI

Nithya Minnah LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boston, MA
National Provider Identifier
1770945404
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
NITHYA MINNAH LLC
Practice address
115 Newbury St Ste 501
Boston, MA 02116-2971
Phone
(617) 536-0365
NPI assigned
Mar 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Nithya MinnahNPI 1417218215
Title
Orthodontist/Owner
Phone
(617) 536-0365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

115 Newbury St Ste 501
Boston, MA 02116-2971

Mailing address

115 Newbury St Ste 501
Boston, MA 02116-2971
Phone (617) 536-0365

Other names 1

  • Minnah & Korn Orthodontics on Newbury Street Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250328002737 MA DME Supplier - Oral Surgery - Dentist 1951824010 Practice locations: Boston, MA

National Provider Directory

National Provider Directory

Locations

115 Newbury St
Ste 501
Boston, MA 02116
Phone (617) 536-0365

Practitioners & affiliated clinicians

Practitioners 1

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": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1770945404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NEWBURY ST STE 501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162971",
            "telephone_number": "617-536-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NEWBURY ST STE 501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162971",
            "telephone_number": "617-536-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NITHYA MINNAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "MINNAH",
        "authorized_official_first_name": "NITHYA",
        "authorized_official_title_or_position": "ORTHODONTIST/OWNER",
        "authorized_official_telephone_number": "617-536-0365"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnah & Korn Orthodontics on Newbury Street",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Minnah & Korn Orthodontics on Newbury Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.