Individual provider Active NPI

Alvin Christopher Miranda, DDS

  • Dentist
  • Bel Air, MD
National Provider Identifier
1467578179
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13020 Issued in MD
Practice address
200 Thomas St
Bel Air, MD 21014
Phone
(410) 420-9705
Fax
(410) 420-9708
NPI assigned
Mar 22, 2007
Last updated
Mar 31, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13020 MD Primary

Addresses

Primary practice location

200 Thomas St
Bel Air, MD 21014

Mailing address

720 Pheasant Dr
Forest Hill, MD 21050-1500
Phone (410) 420-9705

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
13020MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alvin C. Miranda, D.D.S, P.a. Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1467578179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 PHEASANT DR",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210501500",
            "telephone_number": "410-420-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THOMAS ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21014",
            "telephone_number": "410-420-9705",
            "fax_number": "410-420-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ALVIN",
        "middle_name": "CHRISTOPHER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.