Celia Yvonne Mimms, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019029248 Issued in IL

Practice address

2555 W 79TH St
Chicago, IL 60652-1729

Phone

(773) 434-1515

NPI assigned

Oct 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 16, 2021 through Apr 16, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: cmimms18662@direct.midwestern.edu

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.

• Roslyn Travis Stratton D.D.S.,P.C.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1245597020
  NPD (past)

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1871845321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521729",
            "telephone_number": "773-434-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMMS",
        "first_name": "CELIA",
        "middle_name": "YVONNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina C Milunas, RD LDN
• Milwaukee Dental Clinic, Inc
• Mahmoud Mima
• Denise D. Mimbela
• Mimir Consulting PLLC
• Katja Aisha Mimms, LCPC
• Gabrielle Mims
• James Min, M.D.
• Jessica Min, O.D.
• Ji-in Min, PHARMD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.