Jacquelyn Olbina Miller, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DL20231 Issued in FL

Practice address

1699 S 14TH St Ste 21
Fernandina Beach, FL 32034-1965

Phone

(904) 277-8500

NPI assigned

Jul 3, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amelia Gentle Dentistry, LLC

  • Dentist
  • Fernandina Beach, FL
  • NPI 1679969786
  NPD

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1679913610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 21",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-277-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACQUELYN",
        "middle_name": "OLBINA",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DL20231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarla Millar, RPT
• Millennium Physician Group LLC
• Amanda L Miller-Hodges, LMHC, C-DBT
• Alan Edward Miller, M.D.
• Carly J Miller, M.D.
• Colin Milo
• Andrea Miranda, PT
• Nicole Marie Mischler, ARNP
• Barbara Moger, CRNA
• Laura Frances Momnie, SLP

• All providers in Fernandina Beach, FL
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.