Individual provider Active NPI

Kimberly Joi Minor, DDS

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1902918444
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7639 Issued in NC
Practice address
4901 N Tryon St
Charlotte, NC 28213-7033
Phone
(704) 921-0204
Fax
(704) 921-4095
NPI assigned
Aug 31, 2006
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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 7639 NC Primary

Addresses

Primary practice location

4901 N Tryon St
Charlotte, NC 28213-7033

Mailing address

4901 N Tryon St
Charlotte, NC 28213-7033
Phone (704) 921-0204

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
7639NCMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: kimberl.minordds.p1@direct.personfamily.nextgenshare.com

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": "1206576000000",
    "number": "1902918444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282137033",
            "telephone_number": "704-921-0204",
            "fax_number": "704-921-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282137033",
            "telephone_number": "704-921-0204",
            "fax_number": "704-921-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "KIMBERLY",
        "middle_name": "JOI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.