Individual provider Active NPI

Carl K McMillan, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • American Fork, UT
National Provider Identifier
1417036583
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
142879-9922 Issued in UT
Practice address
355 E 50 S
American Fork, UT 84003-3837
Phone
(801) 756-0900
Fax
(801) 756-7290
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 142879-9922 UT
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 142879-9922 UT Primary

Addresses

Primary practice location

355 E 50 S
American Fork, UT 84003-3837

Mailing address

355 E 50 S
American Fork, UT 84003-3837
Phone (801) 756-0900

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
142879-9922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
TMJ Therapy, Inc Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1417036583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E 50 S",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840033837",
            "telephone_number": "801-756-0900",
            "fax_number": "801-756-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E 50 S",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840033837",
            "telephone_number": "801-756-0900",
            "fax_number": "801-756-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "CARL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "142879-9922",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "142879-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.