Derek Miller, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

R674 Issued in MN

Practice address

7-174 Moos Tower 515 Delaware St. S
U of M Oral Surgery
Minneapolis, MN 55455

Phone

(701) 306-4741

NPI assigned

Jun 14, 2017

Last updated

Jun 14, 2017By the provider in NPPES

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 ND

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

Specialty

Oral Surgery

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Face and Jaw Surgeons PCGroup PAC ID 1153311881, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bismarck, ND
  • NPI 1184667305
  Medicare reassignment Care Compare group NPD
• Face & Jaw Surgeons, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickinson, ND
  • NPI 1730897026
  NPD
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Minot, ND
  • NPI 1104863505
  NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1205366002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 TERRITORY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030168",
            "telephone_number": "701-306-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7-174 MOOS TOWER 515 DELAWARE ST. S",
            "address_2": "U OF M ORAL SURGERY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "701-306-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "R674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Miller, LCGC, MS, BS
• Daniel David Miller, M.D.
• Danielle Miller, RN
• David Miller
• Deanna Miller, DDS
• Erin Michelle Miller
• Fanny D Guarnizo Miller, LICSW
• Fawn Gabrielle Miller, LMFT, APCC
• Gary Thomas Miller, D.C.
• Heather Lauren Miller, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.