Cedar Lane Family Dentistry PC

Primary specialty

DentistTaxonomy code 122300000X

License

12009980 Issued in IN

Legal business name

CEDAR LANE FAMILY DENTISTRY PC

Practice address

850 Cedar Lane
Franklin, IN 46131-1089

Phone

(317) 736-7476

Fax

(317) 736-1946

NPI assigned

Dec 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Philip James Mirise, DDSNPI 1245319151

Title

Dentist Ceo

Phone

(317) 736-7476

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip James Mirise, DDS

  • General Practice Dentistry
  • Franklin, IN
  • NPI 1245319151
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1003976093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 CEDAR LANE",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461311089",
            "telephone_number": "317-736-7476",
            "fax_number": "317-736-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 CEDAR LANE",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461311089",
            "telephone_number": "317-736-7476",
            "fax_number": "317-736-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR LANE FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "MIRISE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST CEO",
        "authorized_official_telephone_number": "317-736-7476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200189530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cali Rose Casaburo
• Annabelle Cassetty, RBT
• Rebekah Cassetty
• Kyla Nichole Castro
• Alexandra Taylor Cates
• Peter Gar-Jun Chan, M.D.
• Michaela Sue Cheek, OTR
• Molly Kathryn Chizum, MPT
• McKinley Sue Choate
• Joseph Choga

• Dentist in Franklin, IN
• Providers in Franklin, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.