Scott Randolph Miller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401008559 Issued in VA

Practice address

15325 Lee Hwy
Bristol, VA 24202-4013

Phone

(276) 466-9800

Fax

(276) 591-5959

NPI assigned

Jun 23, 2005

Reactivated

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477559474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15325 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024013",
            "telephone_number": "276-466-9800",
            "fax_number": "276-591-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15325 LEE HWY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024013",
            "telephone_number": "276-466-9800",
            "fax_number": "276-591-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SCOTT",
        "middle_name": "RANDOLPH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Kay Meade, LCSW
• Travis Nathaniel Meade, RN
• Michelle Hejny
• Miller Family & Sports Chiropractic, LLC
• April D Miller, PTA
• Tiffany Miller, RN
• Ricky Donald Mitchell, CSAC, LPC
• Taylor Carol Mitchell
• Sarah Mollohan, PHARMD
• Taylor Moncier, OTR/L

• General Practice Dentistry in Bristol, VA
• Providers in Bristol, VA by specialty
• General Practice Dentistry in Virginia

• 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.

Verify at the official NPI Registry.