Philip James Mirise, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009980 Issued in IN

Practice address

850 Cedar Lane
Franklin, IN 46131-1089

Phone

(317) 736-7476

Fax

(317) 736-1946

NPI assigned

Nov 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Bloomfield Family Dental LLC

  • Dental Clinic/Center
  • Bloomfield, IN
  • NPI 1275389181
  NPD Authorized official
• Cedar Lane Family Dentistry PC

  • Dentist
  • Franklin, IN
  • NPI 1003976093
  NPD (past) Authorized official
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245319151",
    "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": {
        "last_name": "MIRISE",
        "first_name": "PHILIP",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200189530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaela Grace Miller
• Chandler Mills, BS, MS, RBT
• Chloe Milne, RBT
• Nayan Tara Mirchandani, MS OTR
• Cordin Mirise
• MJH Chiropractic, Inc.
• Alek Dane Molenaar
• John E Montgomery, MD
• Rachel Moore
• Craig A Moorman, MD

• General Practice Dentistry in Franklin, IN
• Providers in Franklin, 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 Jul 8, 2007; 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.