Nathan King Miller, D.D.S.

Individual provider Active NPI General Practice Dentistry · Ocean Park, WA

NPI 1104293877 · NPPES record last updated Mar 16, 2020

Key facts

NPI
1104293877
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DE60938377 (WA)
Practice address
21610 Pacific Hwy
Ocean Park, WA 98640-3206
Phone
(360) 665-3000
NPI assigned
Aug 28, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2015018855MOMDDentist

Interoperability endpoints

  • Direct secure messaging: nathan.miller.p1@direct.pueblochc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2015018855 MO
General Practice Dentistry 1223G0001X DE60938377 WA Yes

Addresses

Primary practice location

21610 Pacific Hwy
Ocean Park, WA 98640-3206

Mailing address

2813 Fiddleback St NE
Lacey, WA 98516-4426
Phone (316) 393-4493

Other practice location 1

5122 Yelm Hwy SE
Lacey, WA 98503-5034
Phone (360) 528-7878

Other practice location 2

Building 3406 Alder Ave.
Fort Wainwright, AK 99703-1529
Phone (907) 353-2917

Other providers in Ocean Park, WA

All providers in Ocean Park, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.