Active NPI
Alec Miller Fillmore, DDS
- Dentist
- Reno, NV
National Provider Identifier
1437416013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6203
- Practice address
- 1055 S Wells Ave
Reno, NV 89502-2550 - Phone
- (775) 329-6300
- Fax
- (775) 348-3893
- NPI assigned
- Apr 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6203 | NV | Primary |
| Dentist | 122300000X | 61004 | CA |
Addresses
Primary practice location
1055 S Wells Ave
Reno, NV 89502-2550
Mailing address
680 S Rock Blvd
Reno, NV 89502-4113
Phone (775) 329-6300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150609002418 | NV | Order and Referring Only - Oral Surgery | 3870814361 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6203 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1437416013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 S ROCK BLVD",
"city": "RENO",
"state": "NV",
"postal_code": "895024113",
"telephone_number": "775-329-6300",
"fax_number": "775-348-3893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 S WELLS AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895022550",
"telephone_number": "775-329-6300",
"fax_number": "775-348-3893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FILLMORE",
"first_name": "ALEC",
"middle_name": "MILLER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-19",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "6203",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61004",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.