Organization Active NPI

The Dental Place

  • General Practice Dentistry
  • Muncie, IN
National Provider Identifier
1467612481
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007367A Issued in IN
Legal business name
THE DENTAL PLACE
Practice address
1804 W McGalliard Rd
Muncie, IN 47304-2209
Phone
(765) 282-5655
Fax
(765) 587-0103
NPI assigned
Jun 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Dr. Charles Hugh Miller, D.D.S.
Title
Owner/Dentist
Phone
(765) 282-5655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12007367A IN Primary

Addresses

Primary practice location

1804 W McGalliard Rd
Muncie, IN 47304-2209

Mailing address

1804 W McGalliard Rd
Muncie, IN 47304-2209
Phone (765) 282-5655

Other identifiers 1

IdentifierTypeStateIssuer
200888590MedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1467612481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042209",
            "telephone_number": "765-282-5655",
            "fax_number": "765-587-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042209",
            "telephone_number": "765-282-5655",
            "fax_number": "765-587-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTAL PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HUGH",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "765-282-5655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007367A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200888590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.