Individual provider Active NPI

Minaal Verma

  • Prosthodontics
  • Saint Louis, MO
National Provider Identifier
1780040998
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
019032048 Issued in IL
Practice address
11816 Craig Manor Dr
Saint Louis, MO 63146-5496
Phone
(973) 454-7027
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 2901021739 MI
Prosthodontics 1223P0700X 2019000967 MO
Prosthodontics 1223P0700X 019032048 IL Primary

Addresses

Primary practice location

11816 Craig Manor Dr
Saint Louis, MO 63146-5496

Mailing address

11816 Craig Manor Dr
Saint Louis, MO 63146-5496
Phone (973) 454-7027

Other practice location 1

41980 Manor Park Dr
Apt 122
Novi, MI 48375-2775
Phone (973) 454-7027

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

LicenseStateTypeSpecialty
019032048ILMDProsthodontist
2901021739MIMDProsthodontist
2019000967MOMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1780040998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11816 CRAIG MANOR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465496",
            "telephone_number": "973-454-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11816 CRAIG MANOR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465496",
            "telephone_number": "973-454-7027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41980 Manor Park Dr",
            "address_2": "Apt 122",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483752775",
            "country_code": "US",
            "telephone_number": "973-454-7027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERMA",
        "first_name": "MINAAL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-03-29",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901021739",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MO",
            "license": "2019000967",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019032048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.