Miller Dental

Primary specialty

DentistTaxonomy code 122300000X

License

22079 Issued in TX

Legal business name

MILLER DENTAL

Practice address

3307 Miller Ave Suite a
Fort Worth, TX 76119

Phone

(818) 413-6000

NPI assigned

Mar 29, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Phuong Kim DO, DDS

Title

Dentist

Phone

(817) 413-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1053600262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 S.COOPER ST. 112",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76015",
            "telephone_number": "817-466-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 MILLER AVE SUITE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76119",
            "telephone_number": "818-413-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-413-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417171281",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liana Marie Milis, DO
• Biljana Miljatovic, PHARMD
• Phillip Millan, PTA
• Millard L Tierce IV DO
• Stacy Millen, PTA
• Miller Dental PLLC
• Aaron Miller, PT, DPT, FAAOMPT
• Alison J Miller, PT
• Amanda Rae Miller, APRN, FNP-C
• Andrew Louis Miller, M.D.

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.