Active NPI
Suzan Elizabeth Miller, DDS
- Pediatric Dentistry
- Baltimore, MD
National Provider Identifier
1689965188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 09717
- Practice address
- 650 West Baltimore St.
University of Maryland Dental School
Baltimore, MD 21201 - Phone
- (410) 706-7970
- NPI assigned
- May 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 09717 | MD | Primary |
Addresses
Primary practice location
650 West Baltimore St.
University of Maryland Dental School
Baltimore, MD 21201
Mailing address
650 West Baltimore St.
University of Maryland Dental School
Baltimore, MD 21201
Phone (410) 706-7970
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09717 | MD | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1689965188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 WEST BALTIMORE ST.",
"address_2": "UNIVERSITY OF MARYLAND DENTAL SCHOOL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21201",
"telephone_number": "410-706-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 WEST BALTIMORE ST.",
"address_2": "UNIVERSITY OF MARYLAND DENTAL SCHOOL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21201",
"telephone_number": "410-706-7970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SUZAN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-02",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "09717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.