Individual provider Active NPI

David M Miller, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Commack, NY
National Provider Identifier
1285658120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
041250 Issued in NY
Practice address
160 Commack Rd
Commack, NY 11725-3412
Phone
(631) 499-7266
Fax
(631) 499-7525
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 041250 NY Primary

Addresses

Primary practice location

160 Commack Rd
Commack, NY 11725-3412

Mailing address

160 Commack Rd
Commack, NY 11725-3412
Phone (631) 499-7266

Other identifiers 1

IdentifierTypeStateIssuer
01252877MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120118000061 NY Practitioner - Oral Surgery 3476720384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
State Un of Ny, Stony Brook School of Dental Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

160 Commack Rd
Suite M1
Commack, NY 11725-3412
Phone (631) 499-7266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Commack Oral and Maxillofacial Surgeons PC Oral and Maxillofacial Surgery CurrentSince Dec 16, 1987 Accepting new patients

Locations

160 Commack Rd
Ste M1
Commack, NY 11725
Phone (516) 499-7266

160 Commack Rd
Commack, NY 11725
Phone (631) 499-1200

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285658120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253412",
            "telephone_number": "631-499-7266",
            "fax_number": "631-499-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253412",
            "telephone_number": "631-499-7266",
            "fax_number": "631-499-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "041250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252877",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.