Active NPI
John Charles Minye, DDS
- General Practice Dentistry
- Syracuse, NY
National Provider Identifier
1780691618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61013
- Practice address
- 4834 W Seneca Tpke
Syracuse, NY 13215-2249 - Phone
- (315) 469-7722
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61013 | NY | Primary |
| Dentist | 122300000X | 40470 | CA |
Addresses
Primary practice location
4834 W Seneca Tpke
Syracuse, NY 13215-2249
Mailing address
4834 W Seneca Tpke
Syracuse, NY 13215-2249
Phone (315) 469-7722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40470 | CA | MD | Dentist |
| 61013 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael S Grossman DDS PLLC | General Practice | Current | Accepting new patients |
Locations
4834 W Seneca Tpke
Syracuse, NY 13215
Phone (315) 469-7722
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Syracuse, NY
- NPI 1477261949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1780691618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4834 W SENECA TPKE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132152249",
"telephone_number": "315-469-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4834 W SENECA TPKE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132152249",
"telephone_number": "315-469-7722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINYE",
"first_name": "JOHN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2021-10-04",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "61013",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "40470",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.