Miles Madison, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

37446 Issued in CA

Practice address

350 S Beverly Dr Ste 160
Beverly Hills, CA 90212-4815

Phone

(310) 553-2940

Fax

(310) 553-5096

NPI assigned

Mar 14, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Miles Madison, a Professional Dental Corporation

  dba Dental Specialty Care of Lancaster

  • Dentist
  • Lancaster, CA
  • NPI 1386815058
  NPD Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1477687580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 SANTA ANITA AVE",
            "address_2": "SUITE 201",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917331369",
            "telephone_number": "626-444-2605",
            "fax_number": "626-444-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S BEVERLY DR STE 160",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124815",
            "telephone_number": "310-553-2940",
            "fax_number": "310-553-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "37446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B37446",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Rebeka Madan
• Kourosh Maddahi, DDS
• Tiffany Maddahi
• Ethan Sean Madison, DDS
• Marjan Smith Madison, PSY.D.
• Madkan Dermatology, PC (Mosaic Dermatology)
• Peter Nicholson Maduro, J.D., PSY.D.
• Mafl Medical Inc a Professional Corporation
• Maggie a Carroll MFT PHD
• Magma Care (Garfield Prescription Pharmacy)

• Periodontics in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.