Individual provider Active NPI

Irina Minkova, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1821100611
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050734-1 Issued in NY
Practice address
1810 Jerome Ave FL 2
Brooklyn, NY 11235-3621
Phone
(646) 387-8717
Fax
(718) 975-1075
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 050734-1 NY Primary

Addresses

Primary practice location

1810 Jerome Ave FL 2
Brooklyn, NY 11235-3621

Mailing address

3429 Guider Ave
201
Brooklyn, NY 11235-5206
Phone (646) 387-8717

Other identifiers 1

IdentifierTypeStateIssuer
02442684MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205001913 NY Practitioner - Dentist 3779019443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
New York University College of Dentistry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ready Smile Dental PCGroup PAC ID 2769927508, 3 clinicians

Practice addresses (Care Compare)

1502 E 14TH St
Brooklyn, NY 11230-7283
Phone (718) 709-4611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050734-1NYMDGeneral Practice Dentistry
050734NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ready Smile Dental PC CurrentSince Nov 1, 2024 Accepting new patients
Sunnyside Dental, PC Past Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1821100611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 GUIDER AVE",
            "address_2": "201",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355206",
            "telephone_number": "646-387-8717",
            "fax_number": "718-975-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 JEROME AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353621",
            "telephone_number": "646-387-8717",
            "fax_number": "718-975-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKOVA",
        "first_name": "IRINA",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050734-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02442684",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.