Millennium Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AR3377 Issued in AR

Legal business name

MILLENNIUM DENTAL, PLLC

Practice address

2827 E Millennium PL Ste 1
Fayetteville, AR 72703-6528

Phone

(479) 521-4440

Fax

(479) 521-4443

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Patricia L Webb

Title

Business Manager

Phone

(479) 521-4440

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• C. Chad Johnson, D.D.S., P.A. Former legal business name

Locations

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710188388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 E MILLENNIUM PL STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036528",
            "telephone_number": "479-521-4440",
            "fax_number": "479-521-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 E MILLENNIUM PL STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036528",
            "telephone_number": "479-521-4440",
            "fax_number": "479-521-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "479-521-4440"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "AR3377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER INDIVIDUAL",
            "identifier": "1437163599",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C. Chad Johnson, D.D.S., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mark L Miedema, M.D.
• Mike Buffington, M.D., P.a.
• Andrew Mikles
• Miles M Johnson, M.D. P.a.
• Millennium Dental, PLLC
• Ashley H Miller
• Austin Michael Miller
• Catherine Miller
• Charles Lindsey Miller, M.D.
• Christopher F Miller, PT

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• 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.