David Wayne Miolen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8253 Issued in TN

Practice address

2648 Apd 40
Cleveland, TN 37323

Phone

(423) 472-0709

Fax

(423) 472-0788

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in TN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306965686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 APD 40",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37323",
            "telephone_number": "423-472-0709",
            "fax_number": "423-472-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 APD 40",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37323",
            "telephone_number": "423-472-0709",
            "fax_number": "423-472-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIOLEN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1789566",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4098134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith D. Mills, D.C.
• Robert J Mills, MD
• Robert Steven Mills
• Sherra Sue Mills, NP
• Olivia Faith Mineo
• Kalee Ann Miracle
• Brian C Mitchell, MD
• Jayden O Mitchell
• Savannah Mitchell
• Katie Lauren Monroe

• General Practice Dentistry in Cleveland, TN
• Providers in Cleveland, TN by specialty
• General Practice Dentistry in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.