Healthcare Provider Details

I. General information

NPI: 1346105624
Provider Name (Legal Business Name): MINAL AMIN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 N PEPPER AVE
COLTON CA
92324-6716
US

IV. Provider business mailing address

13054 ARABELLA LN
CERRITOS CA
90703-6125
US

V. Phone/Fax

Practice location:
  • Phone: 909-422-0007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDDS112468
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: