Active NPI
Jeffery L. Miller, DDS
- General Practice Dentistry
- Clayton, NC
National Provider Identifier
1356317465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9689
- Practice address
- 31 Oleander Dr
Clayton, NC 27527-4561 - Phone
- (919) 550-5251
- Fax
- (888) 981-3708
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9977 | TX | |
| General Practice Dentistry | 1223G0001X | 9689 | NC | Primary |
Addresses
Primary practice location
31 Oleander Dr
Clayton, NC 27527-4561
Mailing address
PO Box 749625
Atlanta, GA 30374-9625
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008447701 | Medicaid | TX | |
| 840007 | Other | TX | UNITED CONCORDIA |
| DELTA DENTAL | Other | CA | DELTA DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9977 | TX | MD | Chiropractor |
| 9689 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riccobene Associates Xxvii, DDS, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Raleigh, NC
- NPI 1790256782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1356317465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 749625",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303749625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 OLEANDER DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275274561",
"telephone_number": "919-550-5251",
"fax_number": "888-981-3708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JEFFERY",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "9977",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008447701",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "840007",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "DELTA DENTAL",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.