Individual provider Active NPI

Joshua O Miranda, DMD

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1144474958
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412129 Issued in VA
Practice address
2100 Lynnhaven Pkwy
Suite #100
Virginia Beach, VA 23456-1492
Phone
(757) 416-1400
NPI assigned
Nov 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412129 VA Primary

Addresses

Primary practice location

2100 Lynnhaven Pkwy
Suite #100
Virginia Beach, VA 23456-1492

Mailing address

2100 Lynnhaven Pkwy
Suite #100
Virginia Beach, VA 23456-1492
Phone (757) 416-1400

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

LicenseStateTypeSpecialty
0401412129VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Konikoff Dental Dentist 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": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1144474958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LYNNHAVEN PKWY",
            "address_2": "SUITE #100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561492",
            "telephone_number": "757-416-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LYNNHAVEN PKWY",
            "address_2": "SUITE #100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561492",
            "telephone_number": "757-416-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JOSHUA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.