Nichole S Miller, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7933 Issued in IA

Practice address

3290 Ridgeway Drive
Suite 4
Coralville, IA 52241

Phone

(319) 626-2119

Fax

(319) 626-2315

NPI assigned

Jan 11, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in IA

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1326198433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 RIDGEWAY DR",
            "address_2": "STE 4",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412023",
            "telephone_number": "319-626-2119",
            "fax_number": "319-626-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 RIDGEWAY DRIVE",
            "address_2": "SUITE 4",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-626-2119",
            "fax_number": "319-626-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICHOLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "7933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210906",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Jo Miller, PA-C
• Elijah Thomas Miller, PHARMD
• Lexie Miller
• Lora Jean Miller, TLMFT
• Madisson Miller
• Ryan J Miller, D.C.
• Rebecca Ann Mischel, DNP ARNP FNP-BC
• Aniket Mittal, MD
• Somaia Mohamed, PH.D.
• Vyan Mohamed

• Dentist in Coralville, IA
• Providers in Coralville, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.