Active NPI
Addison Miller, DDS
- Dentist
- Charles City, IA
National Provider Identifier
1164047148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS-09778
- Practice address
- 114 N Main St
Charles City, IA 50616-2015 - Phone
- (641) 228-1803
- NPI assigned
- Jun 15, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DDS-09778 | IA | Primary |
Addresses
Primary practice location
114 N Main St
Charles City, IA 50616-2015
Mailing address
206 Meadow LN
Charles City, IA 50616-4006
Phone (515) 341-6515
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 |
|---|---|---|---|
| DDS-09778 | IA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Dental, Inc. | Dentist | Current | Accepting new patients |
Locations
114 N Main St
Charles City, IA 50616
Phone (641) 228-1803
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.
-
- General Practice Dentistry
- Charles City, IA
- NPI 1992371462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1164047148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 MEADOW LN",
"city": "CHARLES CITY",
"state": "IA",
"postal_code": "506164006",
"telephone_number": "515-341-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 N MAIN ST",
"city": "CHARLES CITY",
"state": "IA",
"postal_code": "506162015",
"telephone_number": "641-228-1803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ADDISON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-15",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charles City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.