Jill Kristine Mioduski, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

10178 Issued in CO

Practice address

1299 Main St Unit C
Windsor, CO 80550-5947

Phone

(970) 674-0717

NPI assigned

Aug 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Noco Ortho PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Windsor, CO
  • NPI 1114679057
  NPD

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1174839740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 MAIN ST UNIT C",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505947",
            "telephone_number": "970-674-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 MAIN ST UNIT C",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505947",
            "telephone_number": "970-674-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIODUSKI",
        "first_name": "JILL",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "10178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Elizabeth Miller, LMFT
• William J Milliken, MD
• Pamela Susanne Milos Valstad, DMD
• Holly Brooke Minning, OTR/L
• Neeka A Minor, PT
• Lauren Moeller, RN
• Tonya Montana, RDH
• Kevin Michael Morissette, DO
• Kathleen Gorman Morris, PT, MED
• Randia Esperanza Morrow, OTR

• Orthodontics and Dentofacial Orthopedics Dentistry in Windsor, CO
• Providers in Windsor, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.