Individual provider Active NPI

David Wai Min, DMD

  • Dentist
  • Fresno, CA
National Provider Identifier
1861912909
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
101425 Issued in CA
Practice address
323 E Bullard Ave Ste 103
Fresno, CA 93710-8620
Phone
(559) 439-9998
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101425 CA Primary

Addresses

Primary practice location

323 E Bullard Ave Ste 103
Fresno, CA 93710-8620

Mailing address

9528 Cortada St Unit F
El Monte, CA 91733-1041
Phone (626) 679-3412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191018001472 CA Order and Referring Only - DentistPractitioner - Dentist 1658602883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101425CAMDDentist

Interoperability endpoints

  • Direct secure messaging: david.min.p1@direct.scfhc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1861912909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9528 CORTADA ST UNIT F",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917331041",
            "telephone_number": "626-679-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E BULLARD AVE STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108620",
            "telephone_number": "559-439-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "DAVID",
        "middle_name": "WAI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.