Provider Demographics
NPI:1700217213
Name:MIRIAM CARMEAN DDS LLC
Entity Type:Organization
Organization Name:MIRIAM CARMEAN DDS LLC
Other - Org Name:CARMEAN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:LEILANI
Authorized Official - Last Name:CARMEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-750-1844
Mailing Address - Street 1:6242 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1846
Mailing Address - Country:US
Mailing Address - Phone:317-650-1362
Mailing Address - Fax:
Practice Address - Street 1:6561 WHITESTOWN PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7621
Practice Address - Country:US
Practice Address - Phone:317-650-1362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011851A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty