Individual provider Active NPI

David Scott Miller, DDS

  • Dentist
  • Saint Joseph, MI
National Provider Identifier
1043223456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901015760 Issued in MI
Practice address
824 Napier Ave
Saint Joseph, MI 49085
Phone
(269) 983-4371
Fax
(269) 983-5304
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901015760 MI Primary

Addresses

Primary practice location

824 Napier Ave
Saint Joseph, MI 49085

Mailing address

824 Napier Ave
Saint Joseph, MI 49085
Phone (269) 983-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812008917 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7416915376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901015760MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043223456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "269-983-4371",
            "fax_number": "269-983-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "269-983-4371",
            "fax_number": "269-983-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.