Marjorie Miller, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017649 Issued in IL

Legal business name

MARJORIE MILLER, D.D.S., P.C.

Practice address

518 Hillgrove Ave
Suite 200
Western Springs, IL 60558-1442

Phone

(708) 246-3635

Fax

(708) 246-3637

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marjorie Miller, D.D.S.NPI 1174619290

Title

Dentist

Phone

(708) 246-3635

Specialties & licenses 1

Addresses

Other names 1

• Western Springs Dental Care Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 18, 2016 through Apr 18, 2028

Medicare enrollment (NPD)

Not enrolled

Practitioners 1

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

• Marjorie Miller, DDS

  • General Practice Dentistry
  • Western Springs, IL
  • NPI 1174619290
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1063581544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE",
            "address_2": "SUITE 200",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581442",
            "telephone_number": "708-246-3635",
            "fax_number": "708-246-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE",
            "address_2": "SUITE 200",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581442",
            "telephone_number": "708-246-3635",
            "fax_number": "708-246-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARJORIE MILLER, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "708-246-3635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Springs Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Loos
• Melissa Lupo
• Renee Lyons
• Alexa Maisenbach, PHARMD
• Edward T Marcoski Jr., MD
• Theresa Marousek
• John Edward Martin, M.D.
• Rebekka Martin, B.A.
• Sarah Moore Martin
• Vivian Masso-Corral

• General Practice Dentistry in Western Springs, IL
• Providers in Western Springs, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.