Active NPI
Emily Ann Miller, D.M.D.
- General Practice Dentistry
- Hawley, MN
National Provider Identifier
1215487228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D14814
- Practice address
- 510 Main Street
Hawley, MN 56549 - Phone
- (218) 483-1038
- Fax
- (701) 282-2572
- NPI assigned
- Oct 13, 2016
- Last updated
- Jul 16, 2024
- Sex
- Female
- 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 | 2305 | ND | |
| General Practice Dentistry | 1223G0001X | D14814 | MN | Primary |
Addresses
Primary practice location
510 Main Street
Hawley, MN 56549
Mailing address
1650 45TH St S
Suite 108
Fargo, ND 58103-3246
Phone (701) 282-2287
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161219001860 | ND | Order and Referring Only - Dentist | 8123309721 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14814 | MN | MD | General Practice Dentistry |
| 2305 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Krista Johnson DMD PLLC | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1215487228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 45TH ST S",
"address_2": "SUITE 108",
"city": "FARGO",
"state": "ND",
"postal_code": "581033246",
"telephone_number": "701-282-2287",
"fax_number": "701-282-2572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 MAIN STREET",
"city": "HAWLEY",
"state": "MN",
"postal_code": "56549",
"telephone_number": "218-483-1038",
"fax_number": "701-282-2572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "EMILY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-13",
"last_updated": "2024-07-16",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ND",
"license": "2305",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D14814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.