NPIMap

Organization Active NPI

Miller DDS of Bridgewater, PC

Doing business as Parkside Family Dentistry

  • General Practice Dentistry
  • Bridgewater, VA
National Provider Identifier
1437489135
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MILLER DDS OF BRIDGEWATER, PC
Doing business as
Parkside Family Dentistry
Practice address
100 Parkside Dr
Bridgewater, VA 22812-1755
Phone
(540) 828-3518
Fax
(540) 828-6667
NPI assigned
Jan 4, 2010
Last updated
Jan 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Dr. Glen R Miller, D.D.S
Title
Doctor/President
Phone
(540) 828-3518

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

100 Parkside Dr
Bridgewater, VA 22812-1755

Mailing address

100 Parkside Dr
Bridgewater, VA 22812-1755
Phone (540) 828-3518

Other names 1

  • Parkside Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

100 Parkside Dr
Bridgewater, VA 22812
Phone (540) 828-3518

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1437489135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARKSIDE DR",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121755",
            "telephone_number": "540-828-3518",
            "fax_number": "540-828-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARKSIDE DR",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121755",
            "telephone_number": "540-828-3518",
            "fax_number": "540-828-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER DDS OF BRIDGEWATER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "540-828-3518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgewater, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.