MEDICARE: MS. IRINA MINKOVA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	050734-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821100611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRINA MINKOVA DDS

Provider Business Mailing Address
First Line	:	3429 GUIDER AVE
Second Line	:	201
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5206
Country	:	US
Telephone Number	:	646-387-8717
Fax Number	:	718-975-1075

Provider Business Practice Location Address
First Line	:	1810 JEROME AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3621
Country	:	US
Telephone Number	:	646-387-8717
Fax Number	:	718-975-1075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/21/2024

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