Dennis Mills, DDS, PC – General Practice Dentistry

Key facts

NPI: 1659577757
Entity type: Organization (NPI type 2)
Primary specialty: General Practice Dentistry 1223G0001X
License: M395 (SD)
Legal business name: DENNIS MILLS, DDS, PC
Practice address: 88 Charles St
Deadwood, SD 57732-1303
Phone: (605) 578-3810
Fax: (605) 578-3812
NPI assigned: Jun 25, 2007
Organization subpart: No

Authorized official

Name: Dr. Dennis M. Mills, D.D.S.
Title: Dentist
Phone: (605) 578-3810

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry Group: 193400000X SINGLE SPECIALTY GROUP	1223G0001X	M395	SD	Yes

Addresses

Primary practice location

88 Charles St
Deadwood, SD 57732-1303

Mailing address

88 Charles St
Deadwood, SD 57732-1303
Phone (605) 578-3810

Other identifiers

Identifier	Type	State	Issuer
7809990	Medicaid	SD

Other names

Deadwood Dental Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 17, 2007.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1659577757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303",
            "telephone_number": "605-578-3810",
            "fax_number": "605-578-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303",
            "telephone_number": "605-578-3810",
            "fax_number": "605-578-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS MILLS, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "605-578-3810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7809990",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deadwood Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Deadwood, SD

All providers in Deadwood, SD · General Practice Dentistry in South Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.