Individual provider Active NPI

Jonathan Millen, DMD

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1083705982
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19070 Issued in MA
Practice address
274 Newbury St
Boston, MA 02116-2403
Phone
(617) 262-0106
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 19070 MA Primary

Addresses

Primary practice location

274 Newbury St
Boston, MA 02116-2403

Mailing address

274 Newbury St
Boston, MA 02116-2403
Phone (617) 262-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150629001256 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850603226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19070MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
42 North Dental Care, LLC Past Accepting new patients

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083705982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 NEWBURY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162403",
            "telephone_number": "617-262-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 NEWBURY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162403",
            "telephone_number": "617-262-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEN",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.