1. Home
  2. Directory
  3. Illinois
  4. Chicago
  5. Clinic Center
  6. NPI Profile

MINTY DENTAL BOUTIQUE
NPI 1457187775
Clinic/Center - Dental in Chicago, IL

Active since September 12, 2024
4200 W PETERSON AVE STE 136, CHICAGO, IL 60646(773) 286-5286(773) 286-5331 Get Directions Write a Review

NPPES record last updated: September 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Minty Dental Boutique NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINTY DENTAL BOUTIQUE (NPI 1457187775) is a healthcare organization registered as a dental in Chicago, Illinois and active in the NPI registry since September 2024. The organization lists Tamara Marjan, Owner, as its authorized official.

NPPES Registry Identity

NPI1457187775
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMINTY DENTAL BOUTIQUE
Location Address4200 W PETERSON AVE STE 136Chicago, IL 60646-6052
Mailing Address4200 W Peterson Ave Ste 136Chicago, IL 60646-6052 · (773) 286-5286
Phone(773) 286-5286
Fax(773) 286-5331
Organization SubpartNo
Authorized OfficialTamara MarjanOwner · (936) 239-0753
Enumeration DateSeptember 12, 2024
NPPES CertifiedSeptember 12, 2024
✔ NPI 1457187775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4200 W PETERSON AVE STE 136, Chicago, IL 60646
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ICO DENTAL, LLC
Clinic/Center (Dental)
4200 W PETERSON AVE STE 136
CHICAGO, IL 60646
Cook County (773) 286-5286

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Minty Dental Boutique's NPI number?

The NPI number for Minty Dental Boutique is 1457187775. It was assigned to this organization in the NPPES registry on September 12, 2024.

Where is Minty Dental Boutique located?

Minty Dental Boutique is located at 4200 W Peterson Ave Ste 136, Chicago, IL 60646. The listed phone number is (773) 286-5286.

What is Minty Dental Boutique's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Minty Dental Boutique was last updated on September 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.