Active NPI
Fredrick H McMillen, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Johnston, RI
National Provider Identifier
1003896697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DENO1479
- Practice address
- 1226 Hartford Ave
Suite 101
Johnston, RI 02919 - Phone
- (401) 331-7171
- Fax
- (401) 331-2527
- NPI assigned
- Jan 19, 2006
- Reactivated
- Jun 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DENO1479 | RI | Primary |
Addresses
Primary practice location
1226 Hartford Ave
Suite 101
Johnston, RI 02919
Mailing address
1226 Hartford Ave
Suite 101
Johnston, RI 02919
Phone (401) 331-7171
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1479 | Other | RI | DELTA DENTAL |
| 89292 | Other | RI | BLUE CROSS |
| FM00711 | Medicaid | RI |
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 |
|---|---|---|---|
| DENO1479 | RI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McMillen Orthodontics LTD | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
| Nordstrom Orthodontics LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Johnston, RI
- NPI 1063433209
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Johnston, RI
- NPI 1255041034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003896697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1226 HARTFORD AVE",
"address_2": "SUITE 101",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "02919",
"telephone_number": "401-331-7171",
"fax_number": "401-331-2527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1226 HARTFORD AVE",
"address_2": "SUITE 101",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "02919",
"telephone_number": "401-331-7171",
"fax_number": "401-331-2527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMILLEN",
"first_name": "FREDRICK",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2007-07-08",
"deactivation_date": "2006-10-02",
"reactivation_date": "2007-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "RI",
"license": "DENO1479",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "1479",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "89292",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FM00711",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.