Individual provider Active NPI

Michael M. Milanovich, D.M.D.

  • Dentist
  • Corpus Christi, TX
National Provider Identifier
1710060637
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35693 Issued in TX
Practice address
5317 S Padre Island Dr
Corpus Christi, TX 78411-4103
Phone
(361) 402-6007
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019022222 IL
Dentist 122300000X 35693 TX Primary

Addresses

Primary practice location

5317 S Padre Island Dr
Corpus Christi, TX 78411-4103

Mailing address

15430 Cruiser St Apt B
Corpus Christi, TX 78418-6762
Phone (618) 530-6276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190930000978 TX Order and Referring Only - DentistPractitioner - Dentist 1951631209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019022222ILMDDentist
35693TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1710060637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15430 CRUISER ST APT B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186762",
            "telephone_number": "618-530-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 S PADRE ISLAND DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114103",
            "telephone_number": "361-402-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANOVICH",
        "first_name": "MICHAEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022222",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.