Provider Demographics
NPI:1366242489
Name:MINT HEALTH DENTAL, PLLC
Entity type:Organization
Organization Name:MINT HEALTH DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-414-2312
Mailing Address - Street 1:33 SLEEPER ST APT 306
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1200
Mailing Address - Country:US
Mailing Address - Phone:609-414-2312
Mailing Address - Fax:
Practice Address - Street 1:33 SLEEPER ST APT 306
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1200
Practice Address - Country:US
Practice Address - Phone:609-414-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty