Individual provider Active NPI

Leighton Thomas Miller, DDS

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1366460545
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4504 Issued in NM
Practice address
3251 Coors Blvd SW Ste E1
Albuquerque, NM 87121-5203
Phone
(505) 208-7565
Fax
(505) 318-1732
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56404 CA
Dentist 122300000X 9973 OR
Dentist 122300000X 92160589921 UT
Dentist 122300000X 33797 TX
Dentist 122300000X DS043347 PA
General Practice Dentistry 1223G0001X 1256 HI
Dentist 122300000X DD4504 NM Primary

Addresses

Primary practice location

3251 Coors Blvd SW Ste E1
Albuquerque, NM 87121-5203

Mailing address

555 W Benjamin Holt Dr
Building B
Stockton, CA 95207-3839

Other practice location 1

2839 Carlisle Blvd NE
Albuquerque, NM 87110-2876
Phone (505) 317-7240

Other practice location 2

75-1028 Henry St
Suite 203
Kailua Kona, HI 96740-1693
Phone (808) 329-4425

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

LicenseStateTypeSpecialty
33797TXMDClinical Psychologist
56404CAMDDentist
DD4504NMMDDentist
9973ORMDDentist
DS043347PAMDDentist
92160589921UTMDDentist
1256HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1366460545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR",
            "address_2": "BUILDING B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 COORS BLVD SW STE E1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215203",
            "telephone_number": "505-208-7565",
            "fax_number": "505-318-1732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2839 Carlisle Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871102876",
            "country_code": "US",
            "telephone_number": "505-317-7240",
            "fax_number": "505-444-6496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75-1028 Henry St",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967401693",
            "country_code": "US",
            "telephone_number": "808-329-4425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "LEIGHTON",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56404",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "9973",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "92160589921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33797",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043347",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "1256",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.