Michael J. Miller, DMD, a Professional Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

44216 Issued in CA

Legal business name

MICHAEL J. MILLER, DMD, A PROFESSIONAL CORPORATION

Practice address

10715 Tierrasanta Blvd
Suite C
San Diego, CA 92124-2610

Phone

(858) 278-6444

Fax

(828) 279-6444

NPI assigned

Jul 2, 2015

Organization subpart

No

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

Authorized official

Name

Alice L Van Dyken

Title

Assistant Office Manager

Phone

(858) 278-6444

Specialties & licenses 1

Addresses

Other names 1

• Tierrasanta Plaza Dental Care Doing business as

Locations

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1306229703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10715 TIERRASANTA BLVD",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242610",
            "telephone_number": "858-278-6444",
            "fax_number": "828-279-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10715 TIERRASANTA BLVD",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242610",
            "telephone_number": "858-278-6444",
            "fax_number": "828-279-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. MILLER, DMD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "VAN DYKEN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "858-278-6444"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "44216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tierrasanta Plaza Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.