Provider Demographics
NPI:1932776473
Name:MINGA ORTHODONTICS LLC
Entity Type:Organization
Organization Name:MINGA ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MINGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:614-800-7352
Mailing Address - Street 1:5454 GOOSE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-1677
Mailing Address - Country:US
Mailing Address - Phone:614-800-7352
Mailing Address - Fax:
Practice Address - Street 1:3769 COLUMBUS PIKE STE 100
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7213
Practice Address - Country:US
Practice Address - Phone:614-800-7352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty