Active NPI
Heather L Lucks Miller, DDS
- Periodontics
- Stony Brook, NY
National Provider Identifier
1285843060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 046628-1
- Practice address
- 2500 Nesconset Hwy
Building 10 Suite 38
Stony Brook, NY 11790-2555 - Phone
- (631) 751-2636
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 046628-1 | NY | Primary |
Addresses
Primary practice location
2500 Nesconset Hwy
Building 10 Suite 38
Stony Brook, NY 11790-2555
Mailing address
PO Box 785
Stony Brook, NY 11790-0785
Phone (631) 751-2636
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 |
|---|---|---|---|
| 046628-1 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285843060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 785",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117900785",
"telephone_number": "631-751-2636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NESCONSET HWY",
"address_2": "BUILDING 10 SUITE 38",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902555",
"telephone_number": "631-751-2636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKS MILLER",
"first_name": "HEATHER",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "046628-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
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.