David Ellman Miranda, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

WV3097 Issued in WV

Practice address

3997 Beckley Rd
Princeton, WV 24740-7660

Phone

(304) 431-5499

Fax

(304) 431-3400

NPI assigned

Feb 4, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1396983961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499",
            "fax_number": "304-431-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499",
            "fax_number": "304-431-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DAVID",
        "middle_name": "ELLMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "WV3097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001735593",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133749000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Mills
• Tara Janae Minnix-Harmon, AU.D., CCC-A
• Monica Minnix
• Charles John Mirabile, M.D.
• Miracles of Life OB/GYN, PLLC
• Michelle Mitchell
• Tara Mitchell, D.O.
• Tracy Jean Mitchell
• Lisa Mitchem
• Zoe Macrina Molineaux

• Dentist in Princeton, WV
• Providers in Princeton, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.