Provider Demographics
NPI:1134416746
Name:MIAN, MICHELLE UMARAH (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:UMARAH
Last Name:MIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 CHESTNUT PL APT 2101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6585
Mailing Address - Country:US
Mailing Address - Phone:919-308-3085
Mailing Address - Fax:
Practice Address - Street 1:5915 S ZANG ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4608
Practice Address - Country:US
Practice Address - Phone:720-330-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-03
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855771122300000X, 1223X0400X
CA653391223X0400X
CO002042601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist