Micheal Eugene Corum, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013860A Issued in IN

Practice address

1499 Windhorst Way Ste 100
Greenwood, IN 46143-8800

Phone

(317) 886-6639

Fax

(888) 547-0377

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alabama Dental Professionals, PC

  • General Practice Dentistry
  • Athens, AL
  • NPI 1013249242
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1023101524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WINDHORST WAY STE 100",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438800",
            "telephone_number": "317-886-6639",
            "fax_number": "888-547-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 WINDHORST WAY STE 100",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438800",
            "telephone_number": "317-886-6639",
            "fax_number": "888-547-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORUM",
        "first_name": "MICHEAL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4084",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013860A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaysie Cornett, RBT
• Matthew Cornwell
• Corporate Dental Centers
• Kyle Allen Correll, RBT
• Riley Cortez
• Corvanta Medical Equip LLC
• Macy Lee Corwin
• Ashley Cory, MSW
• Michael Coryea
• Zoe Coryell

• General Practice Dentistry in Greenwood, IN
• Providers in Greenwood, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.