Main Street Children's Dentistry and Orthodontics of Phoenix LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF PHOENIX LLC

Practice address

3326 Paper Mill Rd
Phoenix, MD 21131-1419

Phone

(410) 321-8144

NPI assigned

Aug 1, 2014

Last updated

Aug 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

VP Insurance Plan Management

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1043628134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 PAPER MILL RD",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "211311419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 PAPER MILL RD",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "211311419",
            "telephone_number": "410-321-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF PHOENIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGEMENT",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lauren A Miller, DPT

• Dentist in Phoenix, MD
• Providers in Phoenix, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.