Edward McMillan

Primary specialty

DentistTaxonomy code 122300000X

License

10823 Issued in SC

Practice address

224 West D. L. Ingram Ave
BLDG 1408
Cannon AFB, NM 88103-5014

Phone

(575) 784-2778

NPI assigned

Apr 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1154176287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 WEST D. L. INGRAM AVE",
            "address_2": "BLDG 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035014",
            "telephone_number": "575-784-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "DGD.10823",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "10823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Lindholm
• Heather Kimbrell Lopez, RN
• Marissa Manipud Marquez, DNP, FNP, RN
• Sara Jean Mathews, MD
• Clifford J McArthur, MS, RDN, CSSD
• Randy C Michael, DO
• Marcia Marie Middel, PH.D.
• Katherine Milam, D.O.
• Paul Joseph Milazzo, M.S.W.
• Lacye Jean Mills, BSN, RN

• Dentist in Cannon AFB, NM
• Providers in Cannon AFB, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.