Individual provider Active NPI

Rex F. Miller, DMD, PC

  • General Practice Dentistry
  • Jacksonville, OR
National Provider Identifier
1285797167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6727 Issued in OR
Practice address
570 Blackstone Aly
Jacksonville, OR 97530-9007
Phone
(541) 899-1924
Fax
(541) 899-4441
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 6727 OR Primary

Addresses

Primary practice location

570 Blackstone Aly
Jacksonville, OR 97530-9007

Mailing address

570 Blackstone Aly
Jacksonville, OR 97530-9007
Phone (541) 899-1924

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

LicenseStateTypeSpecialty
6727ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285797167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 BLACKSTONE ALY",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309007",
            "telephone_number": "541-899-1924",
            "fax_number": "541-899-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 BLACKSTONE ALY",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309007",
            "telephone_number": "541-899-1924",
            "fax_number": "541-899-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "REX",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "DMD, PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "6727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.