Active NPI
Edward J Miller, DDS
- General Practice Dentistry
- Anaconda, MT
National Provider Identifier
1073676045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1599
- Practice address
- 115 W Commercial Ave
Anaconda, MT 59711-2246 - Phone
- (406) 563-6660
- Fax
- (406) 563-2387
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1599 | MT | Primary |
Addresses
Primary practice location
115 W Commercial Ave
Anaconda, MT 59711-2246
Mailing address
PO Box 1178
Anaconda, MT 59711-1178
Phone (406) 563-6660
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110500 | Medicaid | MT | |
| 15994 | Other | MT | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1599 | MT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anaconda Deer Lodge County | Past | Accepting new patients | |
| Anaconda Deer Lodge Co Family Planning | Past | Accepting new patients |
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.
-
- Ambulatory Family Planning Facility
- Anaconda, MT
- NPI 1861511669
-
- Public Health or Welfare Agency
- Anaconda, MT
- NPI 1902962103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073676045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1178",
"city": "ANACONDA",
"state": "MT",
"postal_code": "597111178",
"telephone_number": "406-563-6660",
"fax_number": "406-563-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W COMMERCIAL AVE",
"city": "ANACONDA",
"state": "MT",
"postal_code": "597112246",
"telephone_number": "406-563-6660",
"fax_number": "406-563-2387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "1599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110500",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "15994",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anaconda, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.