NPIMap

Organization Active NPI

Miller DDS of Haymarket, PC

  • General Practice Dentistry
  • Haymarket, VA
National Provider Identifier
1306096607
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401008691 Issued in VA
Legal business name
MILLER DDS OF HAYMARKET, PC
Practice address
6735 Lea Berry Way
Haymarket, VA 20169-2991
Phone
(703) 753-7077
Fax
(703) 753-6973
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Dr. Glen Ray Miller, DDS
Title
President
Phone
(703) 753-7077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401008691 VA Primary

Addresses

Primary practice location

6735 Lea Berry Way
Haymarket, VA 20169-2991

Mailing address

6735 Lea Berry Way
Haymarket, VA 20169-2991
Phone (703) 753-7077

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1306096607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 LEA BERRY WAY",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201692991",
            "telephone_number": "703-753-7077",
            "fax_number": "703-753-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 LEA BERRY WAY",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201692991",
            "telephone_number": "703-753-7077",
            "fax_number": "703-753-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER DDS OF HAYMARKET, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-753-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haymarket, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.