Bruce Williamson Miller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NC4670 Issued in NC

Practice address

3100 Pineridge LN
Gastonia, NC 28056-7092

Phone

(704) 864-2608

Fax

(704) 864-2609

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

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

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477691509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 WEST 11TH AVENUE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28052",
            "telephone_number": "704-865-6002",
            "fax_number": "704-864-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PINERIDGE LN",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280567092",
            "telephone_number": "704-864-2608",
            "fax_number": "704-864-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRUCE",
        "middle_name": "WILLIAMSON",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "NC4670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Mikesh
• Monika Millen, FNP-C
• Sandra Millen, RDH
• Andrew Brian Miller, LCMHC-A
• Beryl M Miller, LCSW
• Caroline Pinkston Miller, OTR/L
• Donna Miller, LCMHCS, ITFS
• Ellen Ferguson Miller, RN
• Kimberly D Miller, LPC
• Kristi Lynn Miller, MA.ED.S, LPC, NCC

• General Practice Dentistry in Gastonia, NC
• Providers in Gastonia, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• 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.