Roger K Miller, D.D.S. PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5035 Issued in NC

Practice address

1303 Plaza Dr.
Kings Mountain, NC 28086

Phone

(704) 739-7956

Fax

(704) 739-1659

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 21, 2016 through Mar 21, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Roger K Miller DDS PA

  • General Practice Dentistry
  • Kings Mountain, NC
  • NPI 1649448549
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306866553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 PLAZA DR.",
            "address_2": "P.O. BOX 638",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "28086",
            "telephone_number": "704-739-7956",
            "fax_number": "704-739-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 PLAZA DR.",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "28086",
            "telephone_number": "704-739-7956",
            "fax_number": "704-739-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROGER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S. PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7995963",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "95963",
            "identifier": "BCBSOF NC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Ivester McSwain, FNP
• Medi Fare Drug Center of Earl, Inc D/B/a Griffin Drug Center
• Medifare Drug Center of Earl Inc (Griffin Drug Center)
• Alexander Mensah, MD
• Lauren Miller
• Mind on My Mental, P.L.L.C (Mind on my mental)
• Angel Minerva, RN
• Hazel Freida Mitchell
• Luisa Fernanda Morales, LCSWA
• Mountain Street Pharmacy Inc

• General Practice Dentistry in Kings Mountain, NC
• Providers in Kings Mountain, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.