John Eric Miller, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS026390L Issued in PA

Practice address

336 Carey Ave
Wilkes Barre, PA 18702-2133

Phone

(570) 824-0693

Fax

(570) 824-0424

NPI assigned

Oct 12, 2006

Sex

Male

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 PA

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386733400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 CAREY AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022133",
            "telephone_number": "570-824-0693",
            "fax_number": "570-824-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CAREY AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022133",
            "telephone_number": "570-824-0693",
            "fax_number": "570-824-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026390L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "MI525796",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian D Miller, DMD
• Donald Eugene Miller II
• Jacob Victor Miller, MD
• Jessica Miller, CNM
• Jessy Miller, CADC
• Laura Miller, RN
• Lori A Miller, LCSW
• Maria A Miller, MS, OTR
• Sarah Miller, PA-C
• Sarah Ann Miller, RPH

• General Practice Dentistry in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.