Dennis R Miller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DENNIS R MILLER, OD

Practice address

101 W 18TH St
La Porte, IN 46350-6631

Phone

(219) 326-8855

Fax

(219) 326-8855

NPI assigned

Mar 24, 2008

Last updated

Oct 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dennis R Miller

Title

Owner

Phone

(219) 326-8855

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1245402882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 18TH ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506631",
            "telephone_number": "219-326-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 18TH ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463506631",
            "telephone_number": "219-326-8855",
            "fax_number": "219-326-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS R MILLER, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-326-8855"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495330",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200495330A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in La Porte, IN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.