Charles Nolan Miller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10738 Issued in MN

Practice address

7631 W 145
Apple Valley, MN 55124-5511

Phone

(952) 432-8696

Fax

(952) 432-8972

NPI assigned

Jul 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles N Miller DDS PA

  dba Distinctive Dental

  • Dentist
  • Apple Valley, MN
  • NPI 1104126168
  NPD (past) Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437165651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7631 W 145",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245511",
            "telephone_number": "952-432-8696",
            "fax_number": "952-432-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7631 W 145",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245511",
            "telephone_number": "952-432-8696",
            "fax_number": "952-432-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHARLES",
        "middle_name": "NOLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10738",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M826",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09092 KU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey R Michell, MD
• Mika Therapy LLC
• Courtney Denise Mike
• Courtney Mikulichek, BC-HIS
• Catherine Nicole Millar, OTR/L
• Mary Anna Miller, LP
• Amy Margaret Mimm, PUBLIC HEALTH NURSE
• Minnesota Dental Professionals, P.C. (Mosaic Dental-Apple Valley)
• Minnesota Dental Professionals, P.C. (Apple Valley Family Dentistry)
• Ellen Jean Minor, OTR/L

• General Practice Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• General Practice Dentistry in Minnesota

• 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.