Clinton Miller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31003 Issued in TX

Practice address

419 W Southwest Loop 323 Ste 300
Tyler, TX 75701-7062

Phone

(903) 251-9292

Fax

(903) 207-8642

NPI assigned

Nov 7, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

• Dylan Patrick DDS, PLLC

  • Pediatric Dentistry
  • Tyler, TX
  • NPI 1871090860
  NPD
• McBride Clinic Inc

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
  • NPI 1053319889

  Physician Assistant

  NPD (past)
• Olympia Orthopaedic Associates PLLC

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1083785398
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1417026097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 W SOUTHWEST LOOP 323 STE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017062",
            "telephone_number": "903-251-9292",
            "fax_number": "903-207-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W SOUTHWEST LOOP 323 STE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017062",
            "telephone_number": "903-251-9292",
            "fax_number": "903-207-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418989601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Miles
• Chipo Shekinah Miles
• Melissa Millan
• Millennium Neonatology of Tyler PLLC
• Amanda Miller, MS,CCC-SLP
• Crystal Miller
• Darell R Miller, CCP
• Dorian Denise Miller, LVN
• Hobert Stanley Miller, LMSW
• Jan Miller

• General Practice Dentistry in Tyler, TX
• Providers in Tyler, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.