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General NPI Number Information
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NPI Number | 1932776473
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Entity Type | Organization
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Legal Business Name | MINGA ORTHODONTICS LLC
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 3769 COLUMBUS PIKE STE 100
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City | DELAWARE
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State | OH
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Zip | 43015-7213
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Country | US
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Telephone | 614-800-7352
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Fax |
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Provider Business Mailing Address
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Address Line | 5454 GOOSE FALLS DR
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City | DUBLIN
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State | OH
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Zip | 43016-1677
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Country | US
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Telephone | 614-800-7352
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Fax |
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Authorized Official
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Title or Position | MANAGER/ ORTHODONTIST
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Name | DR. TIMOTHY RYAN MINGA
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Credential | DDS, MS
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Telephone | 614-800-7352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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