Active NPI
Steven C Miller, MD DDS
- Oral and Maxillofacial Surgery (Dentist)
- Yakima, WA
National Provider Identifier
1467536029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 5294
- Practice address
- 4207 Tieton Drive
Yakima, WA 98908-3347 - Phone
- (509) 965-8911
- Fax
- (509) 965-6143
- NPI assigned
- Oct 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 5294 | WA | Primary |
Addresses
Primary practice location
4207 Tieton Drive
Yakima, WA 98908-3347
Mailing address
4207 Tieton Drive
Yakima, WA 98908-3347
Phone (509) 965-8911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5550504 | Medicaid | WA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5294 | WA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467536029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 TIETON DRIVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083347",
"telephone_number": "509-965-8911",
"fax_number": "509-965-6143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4207 TIETON DRIVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083347",
"telephone_number": "509-965-8911",
"fax_number": "509-965-6143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "STEVEN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "WA",
"license": "5294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5550504",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Yakima, WA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.