DR. MARK DOUGLAS MINTLINE (NPI# 1043642069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043642069 |
| Entity Type | Individual |
| Full Name | DR. MARK DOUGLAS MINTLINE |
| Credential | DDS |
| Practice Address |
795 E. Second St. Suite 8 Pomona CA 91766 |
| Mailing Address |
795 E. Second St. Suite 8 Pomona CA 91766-2007 |
| Practice Telephone | 9097063910 |
| Practice Fax Number | 9094698650 |
| Mailing Telephone | 9097063910 |
| Mailing Fax Number | 9094698650 |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2018-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 62702 | CA | Dental Providers |
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
62702 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1395 Center Dr # D8-12, Gainesville, FL 326100402 | 3522736683 | |
| 2540 Sister Mary Dr, Red Bluff, CA 960804327 | 5306902778 | 5306902229 |
| 740 Solano St, Corning, CA 960213352 | 5306902827 | 5308389026 |
| Street Address |
795 E. SECOND ST. SUITE 8 |
| City | POMONA |
| State | CA |
| Zip Code | 91766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356375463 | Bradley E Habermehl | Optometrist | 795 E. Second St., Suite 2, Pomona, CA 91766 | 2006-07-11 |
| 1649793688 | An Duy Vo | Optometrist | 795 E. Second St., Suite 2, Pomona, CA 91766 | 2017-07-21 |
| 1043731557 | Joseph M Gray | Optometrist | 795 E. Second St., Suite 2, Pomona, CA 91766 | 2017-07-06 |
| 1295187185 | Josephine Lin | Optometrist | 795 E. Second St., Suite 2, Pomona, CA 91766 | 2016-07-05 |
| 1043699382 | Stacy Nina Hu | Optometrist | 795 E. Second St., Suite 2, Pomona, CA 91766 | 2015-05-19 |
| 1538570841 | Saba Sadra | Podiatrist | 795 E. Second St., Suite 7, Pomona, CA 91766-2007 | 2014-05-08 |
| 1700105681 | Clara Kim | Dentist | 795 E. Second St., Suite 8, Pomona, CA 91766 | 2010-05-18 |
| 1962521757 | Mickey Avram Seffinger | Neuromusculoskeletal Medicine & OMM | 795 E. Second St., Suite 5, Pomona, CA 91766-2007 | 2007-03-29 |
| 1306996897 | Trang Bich Nguyen | Dentist | 795 E. Second St., Suite 8, Pomona, CA 91766 | 2007-01-10 |
| 1346398260 | Ray M. Yutani | Family Medicine | 795 E. Second St., Suite 5, Pomona, CA 91766-2007 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999494 | Justine Arce | Massage Therapist | 2063 Rancho Valley Drive Suite 320 #208, Pomona, CA 91766 | 2020-10-15 |
| 1699287938 | Monika Stephanie Wan | Pharmacist | 710 Rio Rancho Road, Pomona, CA 91766 | 2017-10-26 |
| 1306386966 | Teresa Le | Dentist | 1898 Wright St, Pomona, CA 91766 | 2017-03-02 |
| 1770971715 | Hanzel Mendez | Physical Therapist | 1080 Verbena Court, Pomona, CA 91766 | 2014-12-29 |
| 1902223589 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 3 Cottontail Dr, Pomona, CA 91766 | 2014-03-21 |
| 1487075578 | Fenix Health Medical Group, Inc. | Family Medicine | 716 East Mission Blvd., Pomona, CA 91766 | 2013-12-17 |
| 1134556012 | Imperial Hospice, Inc. | Hospice Care, Community Based | 363 S Park Ave Ste 105, Pomona, CA 91766 | 2013-10-08 |
| 1497196349 | Cohen Sedgh, Manavi & Pakravan Dental Corporation | Dentist | 763 Rio Rancho Road Suite120, Pomona, CA 91766 | 2013-07-08 |
| 1245573567 | Terry Chang | Acupuncturist | 3060 W. Temple Ave., Pomona, CA 91766 | 2013-04-04 |
| 1215271085 | Emmanuel Castro | Counselor | 4 Village Loop, Phillips Ranch, CA 91766 | 2012-11-19 |
| Find all providers in zip 91766 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699285379 | Hyun-joo Kang | Dentist | 1887 Wright St, Pomona, CA 91766-1012 | 2017-10-06 |
| 1306386966 | Teresa Le | Dentist | 1898 Wright St, Pomona, CA 91766 | 2017-03-02 |
| 1033506282 | Awad and Moore Dental Corporation | Dentist | 2071 Rancho Valley Dr Ste 140, Pomona, CA 91766-7105 | 2015-04-24 |
| 1497196349 | Cohen Sedgh, Manavi & Pakravan Dental Corporation | Dentist | 763 Rio Rancho Road Suite120, Pomona, CA 91766 | 2013-07-08 |
| 1881901619 | Kwang Jib Kim | Dentist | 594 N. Indian Hill Blvd., Pomona, CA 91767-5302 | 2010-08-31 |
| 1689820128 | Shailesh Manharlal Butala | Dentist | 744 E Holt Ave, Pomona, CA 91767-5601 | 2008-08-15 |
| 1942478490 | Brent Fung | Dentist | 795 E 2nd St # 3016a, Pomona, CA 91766-2007 | 2008-02-19 |
| 1447431887 | M Laura De Lopez Dental Corp | Dentist | 1320 N Garey Avenue, Pomona, CA 91767 | 2007-11-14 |
| 1124141932 | Joshua D. Ilan | Dentist | 18 Thiells Mount Ivy Rd, Suite 1, Pomona, NY 10970-3020 | 2007-04-08 |
| 1407970817 | Estelle Hwei-wan Liou | Dentist | 1524 N Orange Grove Ave, Pomona, CA 91767-3812 | 2007-03-19 |
| Find all providers in POMONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.