Stephen Miklethun DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

050917-1 Issued in NY

Legal business name

STEPHEN MIKLETHUN DDS PC

Doing business as

Riverside Dental

Practice address

338 E State St
Suite a
Herkimer, NY 13350-2026

Phone

(315) 219-5516

Fax

(315) 219-5517

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen John Miklethun, DDSNPI 1619043528

Title

Owner

Phone

(315) 219-5516

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Riverside Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen John Miklethun, DDS

  • Dentist
  • Utica, NY
  • NPI 1619043528
  NPD (past) Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669509212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 E STATE ST",
            "address_2": "SUITE A",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502026",
            "telephone_number": "315-219-5516",
            "fax_number": "315-219-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 E STATE ST",
            "address_2": "SUITE A",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502026",
            "telephone_number": "315-219-5516",
            "fax_number": "315-219-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN MIKLETHUN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKLETHUN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-219-5516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050917-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619043528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Smithson, PT
• Kristen Garrigan Snyder-Branner, LCSW-R
• Andrew John Spiridigloizzi, D.D.S.
• Nancy Stack, RPH
• Nora Catherine Staring, LCSW
• Jennifer Lynne Stottlar, LMSW
• Susan Strobino, RN
• Heidi Strong
• Rachel F Sudore, LMSW
• Superior Home Health Care

• General Practice Dentistry in Herkimer, NY
• Providers in Herkimer, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.