Active NPI
Alexander Dennis Miller, DDS
- Dentist
- Prineville, OR
National Provider Identifier
1215077722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D11198
- Practice address
- 257 NE 2ND St
Prineville, OR 97754-1910 - Phone
- (629) 224-6114
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 029668 | NY | |
| Dentist | 122300000X | D11198 | OR | Primary |
Addresses
Primary practice location
257 NE 2ND St
Prineville, OR 97754-1910
Mailing address
589 Knickerbocker Ave
Brooklyn, NY 11221
Phone (718) 366-9191
Other practice location 1
589 Knickerbocker Ave
Brooklyn, NY 11221
Phone (718) 366-9191
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 |
|---|---|---|---|
| D11198 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexander Miller DDS PC | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Brooklyn, NY
- NPI 1336289842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1215077722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "589 KNICKERBOCKER AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11221",
"telephone_number": "718-366-9191",
"fax_number": "718-417-1305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 NE 2ND ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541910",
"telephone_number": "629-224-6114"
}
],
"practiceLocations": [
{
"address_1": "589 Knickerbocker Ave",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11221",
"country_code": "US",
"telephone_number": "718-366-9191",
"fax_number": "718-417-1305",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "ALEXANDER",
"middle_name": "DENNIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "029668",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D11198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.