Active NPI
Leighton Thomas Miller, DDS
- Dentist
- Albuquerque, NM
National Provider Identifier
1366460545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD4504
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 33797 | TX | MD | Clinical Psychologist |
| 56404 | CA | MD | Dentist |
| DD4504 | NM | MD | Dentist |
| 9973 | OR | MD | Dentist |
| DS043347 | PA | MD | Dentist |
| 92160589921 | UT | MD | Dentist |
| 1256 | HI | MD | General 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.