Active NPI
John David Miller, D.M.D.
- General Practice Dentistry
- Aspen, CO
National Provider Identifier
1124169560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-026265
- Practice address
- 100 E Main St # 1
Aspen, CO 81611-1780 - Phone
- (970) 925-9280
- NPI assigned
- Feb 9, 2007
- Last updated
- Feb 23, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 019-026265 | IL | Primary |
Addresses
Primary practice location
100 E Main St # 1
Aspen, CO 81611-1780
Mailing address
100 E Main St Unit 1
Aspen, CO 81611-1780
Phone (970) 925-9280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370958381 | Other | IL | TAX IDENTIFICATION NUMBER |
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 |
|---|---|---|---|
| 019-026265 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1124169560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E MAIN ST UNIT 1",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111780",
"telephone_number": "970-925-9280",
"fax_number": "970-920-3381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E MAIN ST # 1",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111780",
"telephone_number": "970-925-9280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JOHN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-026265",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "370958381",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aspen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.