Individual provider Active NPI

David L Miller, DDS

  • Dentist
  • Grand Blanc, MI
National Provider Identifier
1669496006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901010006 Issued in MI
Practice address
6011 Porter Rd
Grand Blanc, MI 48439-8538
Phone
(810) 694-2270
Fax
(810) 694-2129
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901010006 MI Primary

Addresses

Primary practice location

6011 Porter Rd
Grand Blanc, MI 48439-8538

Mailing address

6011 Porter Rd
Grand Blanc, MI 48439-8538
Phone (810) 694-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20150501001850 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537488101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669496006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 PORTER RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398538",
            "telephone_number": "810-694-2270",
            "fax_number": "810-694-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 PORTER RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398538",
            "telephone_number": "810-694-2270",
            "fax_number": "810-694-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901010006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.