Michael Lee Minyard, D.M.D, M.P.H.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014462 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912-2960

Phone

(706) 721-2371

NPI assigned

Aug 22, 2012

Sex

Male

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 Nov 16, 2015 through Nov 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Douglas P. Clepper DMD PC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1255378766
  NPD (past)
• Gregory a Clepper DMD, LLC

  • Dental Clinic/Center
  • Augusta, GA
  • NPI 1407325343
  NPD (past)

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1972851954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424755",
            "telephone_number": "404-785-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122960",
            "telephone_number": "706-721-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINYARD",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-22",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Lynn Mims, FNP-BC
• Abby Elizabeth Mincey
• Mindful Mentality, LLC
• Priyanka Minhas, MD
• Nora D Mintz, CRNA
• Miracle Making Ministries, Inc.
• Dwight Paul Mirmow, M.D.
• Ahmad Karim Mirza, MD
• Ali Mirza, MD, MPH
• Faris Anthony Mirza, MD

• Pediatric Dentistry in Augusta, GA
• Providers in Augusta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.