Active NPI
Kaleem Mian, DDS
- Dentist
- Muncie, IN
National Provider Identifier
1467553578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011197A
- Practice address
- 200 E McGalliard Rd
Muncie, IN 47303-2009 - Phone
- (765) 254-1706
- Fax
- (765) 254-1709
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12011197A | IN | Primary |
Addresses
Primary practice location
200 E McGalliard Rd
Muncie, IN 47303-2009
Mailing address
16352 Sedalia Dr
Fishers, IN 46040-9719
Phone (607) 745-3708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011197A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youthful Smiles Children & Family Dentistry, LLC | Current | Accepting new patients | |
| Immediadent PC | Dentist | Past | Accepting new patients |
Locations
200 E McGalliard Rd
Muncie, IN 47303
Phone (765) 254-1706
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Muncie, IN
- NPI 1528671765
-
- Dentist
- Indianapolis, IN
- NPI 1578517132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1467553578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16352 SEDALIA DR",
"city": "FISHERS",
"state": "IN",
"postal_code": "460409719",
"telephone_number": "607-745-3708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E MCGALLIARD RD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473032009",
"telephone_number": "765-254-1706",
"fax_number": "765-254-1709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIAN",
"first_name": "KALEEM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2020-10-28",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12011197A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.