Individual provider Active NPI

Michael Craney, DMD

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1760062053
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013770A Issued in IN
Practice address
6225 W 56TH St Ste 100
Indianapolis, IN 46254-0002
Phone
(317) 293-3300
NPI assigned
Apr 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013770A IN Primary

Addresses

Primary practice location

6225 W 56TH St Ste 100
Indianapolis, IN 46254-0002

Mailing address

14230 Blanket Flower LN Apt 204
Noblesville, IN 46060-8730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20220818002585 IN Order and Referring Only - DentistPractitioner - Dentist 6507249869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12013770AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yorktown Dental, LLC Dentist Current Accepting new patients
MFDC of Indiana, Inc PastSince Jul 3, 2022 Accepting new patients
Kim E. Harris, D.D.S., P.C. PastSince Jul 3, 2022 Accepting new patients

Locations

2001 S Tiger Dr
Yorktown, IN 47396
Phone (765) 759-2273

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1618099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1760062053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14230 BLANKET FLOWER LN APT 204",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460608730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 W 56TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462540002",
            "telephone_number": "317-293-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANEY",
        "first_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-11",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013770A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.