Brian D Miles, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6872175-9921 Issued in UT

Practice address

5640 Wasatch Dr
Ste. a
South Ogden, UT 84403-4902

Phone

(801) 479-6590

Fax

(801) 479-6755

NPI assigned

Feb 6, 2008

Last updated

Jun 20, 2011By the provider in NPPES

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

Enrolled in UT

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1639357254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 WASATCH DR",
            "address_2": "STE. A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034902",
            "telephone_number": "801-479-6590",
            "fax_number": "801-479-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 WASATCH DR",
            "address_2": "STE. A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034902",
            "telephone_number": "801-479-6590",
            "fax_number": "801-479-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "BRIAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6872175-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail McBride, RBT
• Karen McBride, CNM
• Med Way Medical, Inc
• Medical Mobile Imaging, LLC
• Violet Clara Merten
• Candace Miles
• Julia Miller, RBT
• Symera Miller, RBT
• Megan Millerberg, RBT
• Heather Mitchell, RN, BSN

• General Practice Dentistry in South Ogden, UT
• Providers in South Ogden, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.