Robert L Miracle, DMD, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4 5347 Issued in OK

Legal business name

ROBERT L MIRACLE, DMD, PC

Practice address

1810 NW Ferris Ave
Lawton, OK 73507-5625

Phone

(580) 355-1314

Fax

(580) 355-1027

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert Miracle, DMDNPI 1518955111

Title

President

Phone

(580) 355-1314

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Miracle, DMD

  • General Practice Dentistry
  • Lawton, OK
  • NPI 1518955111
  NPD (past) Authorized official

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1053635615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 NW FERRIS AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735075625",
            "telephone_number": "580-355-1314",
            "fax_number": "580-355-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 NW FERRIS AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735075625",
            "telephone_number": "580-355-1314",
            "fax_number": "580-355-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L MIRACLE, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "MIRACLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-355-1314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "4 5347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124580B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurette Elizabeth Rivers, APRN, CPNP-PC, CLC
• Alicia Roa
• Roadback Incorporated
• Roadback, Inc.
• Minda Unidad Roan, MD
• Robert M Love MD Inc
• Robert Miles Chisholm III MD PLLC
• Robert Muller DDS PC
• Crystal Roberts
• Jaime Noel Roberts

• Dental Clinic/Center in Lawton, OK
• Providers in Lawton, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.