NPIMap

Organization Active NPI

Charles N Miller DDS PA

Doing business as Distinctive Dental

  • Dentist
  • Apple Valley, MN
National Provider Identifier
1104126168
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10738 Issued in MN
Legal business name
CHARLES N MILLER DDS PA
Doing business as
Distinctive Dental
Practice address
7631 145TH St W
Apple Valley, MN 55124-5511
Phone
(952) 432-8696
NPI assigned
Oct 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Authorized official

Name
Dr. Charles N Miller, DDSNPI 1437165651
Title
President
Phone
(612) 718-3149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D10738 MN Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D7255 MN

Addresses

Primary practice location

7631 145TH St W
Apple Valley, MN 55124-5511

Mailing address

7631 145TH St W
Apple Valley, MN 55124-5511
Phone (952) 432-8696

Other names 1

  • Distinctive Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Charles N Miller DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7631 145th St W
Apple Valley, MN 55124
Phone (952) 432-8696

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1104126168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 145TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245511",
            "telephone_number": "952-432-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7631 145TH ST W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245511",
            "telephone_number": "952-432-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES N MILLER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-718-3149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10738",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D7255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.