Individual provider Active NPI

Amanda Frances Miller, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1053673780
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011810A Issued in IN
Practice address
8920 Southpointe Dr
Suite a-1
Indianapolis, IN 46227-7509
Phone
(317) 881-8161
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12011810A IN Primary

Addresses

Primary practice location

8920 Southpointe Dr
Suite a-1
Indianapolis, IN 46227-7509

Mailing address

8920 Southpointe Dr
Suite a-1
Indianapolis, IN 46227-7509
Phone (317) 881-8161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160708000947 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951693167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011810AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Miller DDS LLC General Practice CurrentSince Oct 13, 2024 Accepting new patients
David H. Wolf DDS Family Dentistry PC Past Accepting new patients

Locations

8920 Southpointe Dr
Ste A1
Indianapolis, IN 46227
Phone (317) 881-8161

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1053673780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 SOUTHPOINTE DR",
            "address_2": "SUITE A-1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277509",
            "telephone_number": "317-881-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 SOUTHPOINTE DR",
            "address_2": "SUITE A-1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277509",
            "telephone_number": "317-881-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AMANDA",
        "middle_name": "FRANCES",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011810A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.