Provider Demographics
NPI:1033216882
Name:MINER, DANIEL IAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:IAN
Last Name:MINER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DOWNING AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2461
Mailing Address - Country:US
Mailing Address - Phone:785-625-2200
Mailing Address - Fax:785-625-0079
Practice Address - Street 1:1010 DOWNING AVE STE 10
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2461
Practice Address - Country:US
Practice Address - Phone:785-625-2200
Practice Address - Fax:785-625-0079
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS920258OtherUNITED CONCORDIA
KS100388340-BMedicaid
KS0920258OtherTRICARE TDP
KS116705OtherBLUE CROSS BLUE SHIELD