Active NPI
Andrew James Miller, DMD
- Dentist
- Boston, MA
National Provider Identifier
1497010292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL 11602
- Practice address
- 30 E Concord St Apt 5
Boston, MA 02118-1966 - Phone
- (617) 997-5501
- NPI assigned
- Jul 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DL 11602 | MA | Primary |
Addresses
Primary practice location
30 E Concord St Apt 5
Boston, MA 02118-1966
Mailing address
30 E Concord St Apt 5
Boston, MA 02118-1966
Phone (617) 997-5501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160408001514 | MA | Order and Referring Only - Oral Surgery | 9335447234 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL 11602 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341705600000",
"number": "1497010292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E CONCORD ST APT 5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181966",
"telephone_number": "617-997-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E CONCORD ST APT 5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181966",
"telephone_number": "617-997-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ANDREW",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-08",
"last_updated": "2012-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL 11602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2012; 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.