Individual provider Active NPI

Joseph Anthony Miller, D.M.D.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1659938108
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014170A Issued in IN
Practice address
1555 S Harding St
Indianapolis, IN 46221-1873
Phone
(317) 775-1288
NPI assigned
May 21, 2019
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901600454 MI
General Practice Dentistry 1223G0001X 12014170A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1555 S Harding St
Indianapolis, IN 46221-1873

Mailing address

9611 White Hemlock LN
Charlotte, NC 28270-4416
Phone (440) 829-6081

Other practice location 1

1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-6552

Other practice location 2

1900 Packard Rd
Ypsilanti, MI 48197-1851
Phone (734) 482-7466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12014170AINMDGeneral Practice Dentistry
2901600454MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1659938108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 WHITE HEMLOCK LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282704416",
            "telephone_number": "440-829-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S HARDING ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462211873",
            "telephone_number": "317-775-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Packard Rd",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971851",
            "country_code": "US",
            "telephone_number": "734-482-7466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600454",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014170A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.