DOMINIC J MINTALUCCI


Address: 1405 Montgomery Dr, Santa Rosa, CA 95405-4557
Phone: 7075461922

DOMINIC J MINTALUCCI (NPI# 1114126869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114126869
Entity Type Individual
Full Name DOMINIC J MINTALUCCI
Credential M.D.
Practice Address 1405 Montgomery Dr
Santa Rosa
CA 95405-4557
Practice Telephone 7075461922
Practice Fax Number 7075461897
Mailing Telephone 7075461922
Mailing Fax Number 7075461897
Enumeration Date 2007-07-13
Last Update Date 2013-10-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207X00000X Orthopaedic Surgery A126421 CA Allopathic & Osteopathic Physicians
Y 207XS0106X Orthopaedic Surgery
Specialization: Hand Surgery
A126421 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA LICENSE A126421 01

Office Location

Street Address 1405 MONTGOMERY DR
City SANTA ROSA
State CA
Zip Code 95405-4557

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750365102 Michael James Mcdermott Orthopaedic Surgery 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2005-11-30
1487118105 Rodney Gerrit Dekleuver Physician Assistant 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2019-01-27
1083010813 Nadine Raymond Occupational Therapist 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2014-11-05
1043471279 Christian Nabil Athanassious Orthopaedic Surgery 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2008-06-20
1720272313 Neema Pourtaheri Orthopaedic Surgery 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-08-28
1891997227 Jennifer Henshaw-lefever Occupational Therapist 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-06-05
1164637922 Santa Rosa Orthopaedic Medical Group, Inc. Orthopaedic Surgery 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-05-14
1477765931 Robert J Smith Physician Assistant 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-05-04
1588876049 Patricia K Hall Physical Therapist 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-05-04
1821200395 Christopher T Krug Physical Therapist 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083230486 Lizett Camacho Counselor 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 2020-06-22
1346768918 Ingrid Tsong Student in an Organized Health Care Education/Training Program 3447 Summerfield Road, Santa Rosa, CA 95405 2017-09-05
1275051898 Jessica Peters Malmberg Student in an Organized Health Care Education/Training Program 2447 Summerfield Rd, Santa Rosa, CA 95405 2017-09-04
1306246772 Kirsten Eckert Advanced Practice Midwife 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 2014-09-03
1982034294 Mohammad Reza Saeidi Dentist 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 2013-11-22
1851631642 Debi M. Emmons Marriage & Family Therapist 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 2013-02-15
1841549979 Karie Louise Klim Marriage & Family Therapist 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 2012-09-05
1427314400 Rachel E. Page Counselor 2447 Summerfield Rd., Santa Rosa, CA 95405 2012-04-04
1689991572 Center for Integral Healing Inc. Community Health Worker 182 Farmers Lane, #203, Santa Rosa, CA 95405 2010-04-30
1588997647 Kai Morgan Dentist 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 2009-09-08
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Taxonomy Information

Taxonomy Code 207XS0106X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Hand Surgery

Taxonomy Definition

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437713500 Santa Rosa Orthopaedic Medical Group, Inc. Orthopaedic Surgery 34 Mark West Springs Rd Ste 300, Santa Rosa, CA 95403-1783 2019-04-24
1164637922 Santa Rosa Orthopaedic Medical Group, Inc. Orthopaedic Surgery 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 2007-05-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477027050 Bay Area Surgical Specialists Orthopaedic Surgery 2505 Samaritan Dr Ste 208, San Jose, CA 95124-4008 2019-01-16
1316484504 James Angus Turner Orthopaedic Surgery 2190 Washington St, Suite 404, San Francisco, CA 94109-2869 2017-01-25
1477906717 Phuc Dang, Md Corporation Orthopaedic Surgery 1006 Mission Dr Apt A, Suite 200, Costa Mesa, CA 92626-4217 2016-07-21
1528423506 H. Relton Mccarroll Jr. Md A Medical Corporation Orthopaedic Surgery 2351 Clay St Ste 510, San Francisco, CA 94115-1931 2015-12-17
1598174492 Paul J. Casey, Md Inc Orthopaedic Surgery 969 Blue Heron, Seal Beach, CA 90740-5611 2014-08-05
1023428901 Austin Arlo Pitcher Orthopaedic Surgery 3315 Broadway Fl 1, Oakland, CA 94611-5717 2014-05-01
1932547536 Hassan Jon Azimi Orthopaedic Surgery 8008 Frost St Ste 403, San Diego, CA 92123-4209 2013-06-06
1114265949 Wayne Pan Orthopaedic Surgery 1475 Grandview Dr, Ms 354-g, Room 354171, South San Francisco, CA 94080-4901 2013-01-29
1720348162 Ryu Yoshida Orthopaedic Surgery 8635 W 3rd St Ste 990w, Los Angeles, CA 90048-6116 2012-05-19
1285933424 Anna Marie Acosta Orthopaedic Surgery 1760 Termino Ave Ste 308, Long Beach, CA 90804 2011-03-25
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Competitor

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City SANTA ROSA
Zip Code 95405

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Dataset Information

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.

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