Organization Active NPI

Alexander Miller DDS PC

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1336289842
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
029668 Issued in NY
Legal business name
ALEXANDER MILLER DDS PC
Practice address
589 Knickerbocker Ave
Brooklyn, NY 11221
Phone
(718) 366-9191
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Mr. Edward Elihue Nolan
Title
Manager
Phone
(718) 366-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 029668 NY Primary

Addresses

Primary practice location

589 Knickerbocker Ave
Brooklyn, NY 11221

Mailing address

589 Knickerbocker Ave
Brooklyn, NY 11221
Phone (718) 366-9191

Other identifiers 1

IdentifierTypeStateIssuer
00699665MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1336289842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11221",
            "telephone_number": "718-366-9191",
            "fax_number": "718-417-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11221",
            "telephone_number": "718-366-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDER MILLER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ELIHUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-366-9191",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "029668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00699665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.