Michael Eldan Kanellis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6343 Issued in NV

Practice address

2351 Pyramid Way Ste 22
Sparks, NV 89431-2163

Phone

(775) 359-5072

NPI assigned

Jul 23, 2013

Last updated

Jan 16, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1316389919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 PYRAMID WAY STE 22",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894312163",
            "telephone_number": "775-359-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 PYRAMID WAY STE 22",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894312163",
            "telephone_number": "775-359-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANELLIS",
        "first_name": "MICHAEL",
        "middle_name": "ELDAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jassica Kailey
• Robert Llyod Kaiser
• Magda Hakim Kalmer
• Mary C Kalna, R.N.
• Daniel P Kane, NCTMB, LMT
• James Kang, D.D.S
• Muskan Kapila
• Tayler Karas
• Rachel Karlen, DO
• Katheryne W Glantz LTD

• Dentist in Sparks, NV
• Providers in Sparks, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.