Individual provider Active NPI

Monil Jatin Mehta, DMD

  • General Practice Dentistry
  • Farmington, MN
National Provider Identifier
1790354181
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14601 Issued in MN
Practice address
20700 Chippendale Ave
Unit 10
Farmington, MN 55024
Phone
(651) 315-8229
NPI assigned
Jun 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14601 MN Primary

Addresses

Primary practice location

20700 Chippendale Ave
Unit 10
Farmington, MN 55024

Mailing address

20700 Chippendale Ave
Unit 10
Farmington, MN 55024
Phone (651) 315-8229

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D14601MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry of the Ponds P.L.L.C. General Practice Current Accepting new patients
St. Louis Park Dental PLLC General Practice Current Accepting new patients
Modern Dental Professionals, MN PC General Practice PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1790354181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20700 CHIPPENDALE AVE",
            "address_2": "UNIT 10",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "55024",
            "telephone_number": "651-315-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20700 CHIPPENDALE AVE",
            "address_2": "UNIT 10",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "55024",
            "telephone_number": "651-315-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "MONIL",
        "middle_name": "JATIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.

Verify at the official NPI Registry.