Individual provider Active NPI

David Miller, D.M.D.

  • Dentist
  • Salem, OR
National Provider Identifier
1205235405
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10118 Issued in OR
Practice address
2605 State St
Salem, OR 97310-1346
Phone
(503) 373-1846
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10118 OR Primary

Addresses

Primary practice location

2605 State St
Salem, OR 97310-1346

Mailing address

2605 State St
Salem, OR 97310-1346
Phone (503) 373-1846

Other practice location 1

12596 SE Stark St
Portland, OR 97233-1056
Phone (503) 252-9657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20160108000943 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012219959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10118ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1205235405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973101346",
            "telephone_number": "503-373-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973101346",
            "telephone_number": "503-373-1846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12596 SE Stark St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972331056",
            "country_code": "US",
            "telephone_number": "503-252-9657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.