Michael James Kanellis, DDS MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

06521 Issued in IA

Practice address

322 S Dental Science BLDG
Iowa City, IA 52242-1001

Phone

(319) 384-1139

Fax

(319) 384-1785

NPI assigned

Sep 12, 2006

Last updated

Feb 21, 2013By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkanellis3892@uihcdirect.org

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

• State University of Iowa

  dba University of Iowa Health Care

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment NPD
• State University of Iowa

  dba College of Dentistry

  • Dentist
  • Iowa City, IA
  • NPI 1609956234
  NPD
• State University of Iowa

  dba Student Health & Wellness

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1518061209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S DENTAL SCIENCE BLDG",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7431",
            "fax_number": "319-335-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 S DENTAL SCIENCE BLDG",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-384-1139",
            "fax_number": "319-384-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANELLIS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IA",
            "license": "06521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007047",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara J Kane, CRNA
• Jenna Kane
• Jesse Kane
• Megan Gail Kane, M.D.
• Shriya Gopal Kane
• Yinqian Kang
• Lauren A Kanner, MD
• Jhanvi Kanotra, MD
• Abhishek Kantamneni, MD
• Simon Kao, MD

• Pediatric Dentistry in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Pediatric Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.