Active NPI
John W Miller, DMD
- Dentist
- Edmonton, KY
National Provider Identifier
1629148481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8177
- Practice address
- 108 Elmore Street
Edmonton, KY 42129 - Phone
- (270) 432-7211
- Fax
- (270) 432-7215
- NPI assigned
- Nov 9, 2006
- Last updated
- Jun 19, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8177 | KY | Primary |
| General Practice Dentistry | 1223G0001X | 8177 | KY |
Addresses
Primary practice location
108 Elmore Street
Edmonton, KY 42129
Mailing address
PO Box 269
Edmonton, KY 42129
Phone (270) 432-7211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- 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 |
|---|---|---|---|---|
| I20151203001439 | KY | Order and Referring Only - Dentist | 5395045934 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8177 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213833600000",
"number": "1629148481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 269",
"city": "EDMONTON",
"state": "KY",
"postal_code": "42129",
"telephone_number": "270-432-7211",
"fax_number": "270-432-7215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 ELMORE STREET",
"city": "EDMONTON",
"state": "KY",
"postal_code": "42129",
"telephone_number": "270-432-7211",
"fax_number": "270-432-7215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JOHN",
"middle_name": "W",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2008-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "8177",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "8177",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonton, KY
- Metcalfe Family Physicians
- Metcalfe Health Services, Inc. (Metcalfe Health Care Center)
- Metcalfe Health Services, Inc. (Metcalfe County Adult Day Care)
- Metcalfe Opco LLC
- Rita Milby, LPCA
- Laura Dale Miller
- Christen Montgomery, CASE MANAGER
- Kathy Lynn Moss, APRN, PMHNP, B-C
- Chastity Renee Munoz, LPCC
- James B Murley, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.