Healthcare Provider Details

I. General information

NPI: 1063760833
Provider Name (Legal Business Name): MINTI AGARWAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 PINEVILLE MATTHEWS RD STE 200
CHARLOTTE NC
28226-6182
US

IV. Provider business mailing address

7227 PINEVILLE MATTHEWS RD STE 200
CHARLOTTE NC
28226-6182
US

V. Phone/Fax

Practice location:
  • Phone: 704-542-7555
  • Fax:
Mailing address:
  • Phone: 704-542-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14253
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: