Organization Active NPI

Richard T Miller DMD PC

Doing business as Great Neck Dental Associates

  • Dentist
  • Great Neck, NY
National Provider Identifier
1144926221
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RICHARD T MILLER DMD PC
Doing business as
Great Neck Dental Associates
Practice address
611 Northern Blvd Ste 100
Great Neck, NY 11021-5208
Phone
(781) 562-0457
Fax
(339) 237-3307
NPI assigned
Feb 1, 2023
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RICHARD T MILLER DMD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Lorraine Matheus
Title
Credentialing
Phone
(781) 562-0457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

611 Northern Blvd Ste 100
Great Neck, NY 11021-5208

Mailing address

500 Chapman St
Canton, MA 02021-2093
Phone (781) 562-0467

Other practice location 1

500 Chapman St
Canton, MA 02021-2093
Phone (781) 562-0467 ext. 1015

Other names 1

  • Great Neck Dental Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Richard T Miller DMD PC2 organizations share this tax ID, including this one
Part of
Richard T Miller DMD PC

Other organizations with this tax ID 1

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

Locations

611 Northern Blvd
Ste 100
Great Neck, NY 11021
Phone (516) 487-5500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1144926221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHAPMAN ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212093",
            "telephone_number": "781-562-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NORTHERN BLVD STE 100",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215208",
            "telephone_number": "781-562-0457",
            "fax_number": "339-237-3307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Chapman St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020212093",
            "country_code": "US",
            "telephone_number": "781-562-0467 x1015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RICHARD T MILLER DMD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICHARD T MILLER DMD PC",
        "enumeration_date": "2023-02-01",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MATHEUS",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "781-562-0457"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Neck Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Neck Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.