Camilla L Miskovich, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10603 Issued in NC

Practice address

1730 Matthews Township Pkwy Ste D
Matthews, NC 28105-4928

Phone

(704) 703-7232

Fax

(704) 703-2327

NPI assigned

Jun 17, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Dr. Camilla L Miskovich Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmiskovich536485@carolinashealthcaresystem.direct-ci.com

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.

• Camilla L Miskovich DMD PLLC

  • Pediatric Dentistry
  • Matthews, NC
  • NPI 1972220762
  NPD Authorized official
• Valleygate Dental Surgery Center of Charlotte LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1720573587

  Pediatric Dentistry

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1013398783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 MATTHEWS TOWNSHIP PKWY STE D",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054928",
            "telephone_number": "704-703-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 MATTHEWS TOWNSHIP PKWY STE D",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054928",
            "telephone_number": "704-703-7232",
            "fax_number": "704-703-2327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8415 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282629768",
            "country_code": "US",
            "telephone_number": "704-336-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11223 Davinci Dr",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280367799",
            "country_code": "US",
            "telephone_number": "704-459-3739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISKOVICH",
        "first_name": "CAMILLA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21214",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9604",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "10603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLA",
            "last_name": "MISKOVICH",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mindfully Balanced Therapy PLLC
• Mindspace Counseling, PLLC.
• Julie Minneci, LCSW
• Claudiu Samuel Mioc, PA-C
• Miracles Can Happen Chiropractic and Nutrition PLLC
• Colee Michelle Mitchell, MD
• Samantha Elaine Mitchell, PHARM D
• Cassidy Marie Modesti, FNP-C
• Louis E Molnar, RPH
• Jeffrey Daniel Monaco, DMD

• Pediatric Dentistry in Matthews, NC
• Providers in Matthews, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.

Verify at the official NPI Registry.