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MS. KHIN MIMI SAN BCHD
NPI 1689116113
Dentist - Periodontics in Va Beach, VA

Active since November 15, 2016Opted out of Medicare · through Aug 8, 2027
477 VIKING DRIVE, SUITE 190, VA BEACH, VA 23452(757) 486-8181(757) 463-0148 Get Directions Write a Review

NPPES record last updated: May 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 21, 2021, Nov 15, 2016 (2 updates tracked since 2016).

About Ms. Khin Mimi San Bchd NPPES

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

MS. KHIN MIMI SAN BCHD (NPI 1689116113) is an individual periodontics provider in Va Beach, Virginia, licensed in Virginia (0401416690) and active in the NPI registry since November 2016. She has opted out of Medicare through August 8, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1689116113
Entity TypeIndividualFemale
Primary Taxonomy1223P0300X
Provider Legal NameMS. KHIN MIMI SANCredential: BCHD
Location Address477 VIKING DRIVE, SUITE 190Va Beach, VA 23452-7354
Mailing Address477 Viking Drive, Suite 190Va Beach, VA 23452-7354 · (757) 486-8181 · Fax (757) 463-0148
Phone(757) 486-8181
Fax(757) 463-0148
Sole ProprietorNo
Enumeration DateNovember 15, 2016
Last NPPES UpdateMay 21, 20212 updates tracked since enumeration
NPPES CertifiedMay 21, 2021
✔ NPI 1689116113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in VA · 0401416690
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
477 VIKING DRIVE, Va Beach, VA 23452
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Khin Mimi San Bchd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 8, 2019 through August 8, 2027.

Opt-Out Effective DateAugust 8, 2019
Opt-Out In Effect ThroughAugust 8, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23452 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

DRS BUSSEY MAYO & ARCHER LTD
Dentist (Endodontics)
477 VIKING DRIVE, STE #215
VIRGINIA BEACH, VA 23452
Virginia Beach City (757) 486-5428

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 Khin Mimi San's NPI number?

The NPI number for Khin Mimi San is 1689116113. It was assigned to this individual provider in the NPPES registry on November 15, 2016.

Where is Khin Mimi San located?

Khin Mimi San practices at 477 Viking Drive Suite 190, VA Beach, VA 23452. The listed phone number is (757) 486-8181.

What is Khin Mimi San's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Khin Mimi San enrolled in Medicare?

No. Khin Mimi San has opted out of Medicare through August 8, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Khin Mimi San accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana and 2 other insurers list Khin Mimi San as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Khin Mimi San was last updated on May 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.