Active NPI
Minaal Verma
- Prosthodontics
- Saint Louis, MO
National Provider Identifier
1780040998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 019032048
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 019032048 | IL | MD | Prosthodontist |
| 2901021739 | MI | MD | Prosthodontist |
| 2019000967 | MO | MD | Prosthodontist |
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.