Jacob Stephen Miller, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

L2251493 Issued in MI

Practice address

5001 Plainfield Ave NE Ste a
Grand Rapids, MI 49525-1050

Phone

(616) 364-7039

NPI assigned

May 29, 2012

Sex

Male

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1184984874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 LINWOOD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732315",
            "telephone_number": "616-901-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 PLAINFIELD AVE NE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251050",
            "telephone_number": "616-364-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACOB",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "L2251493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginny Marie Miller
• Grace Audrey Miller
• Gregory Lance Miller, M.D.
• Haley Lee Miller
• Hannah Marie Miller, LLMSW
• Jana Miller
• Janet Susan Miller, LMSW
• Jay A. Miller, MA, LLP
• Jeffrey H Miller, MD
• Jessica Miller, LLMSW

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.