Individual provider Active NPI

Matthew J Milana, D.D.S.

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1730142118
Registry record updated Jun 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5590 Issued in AZ
Practice address
4214 E Indian School Rd
Ste 102
Phoenix, AZ 85018-5337
Phone
(602) 957-2170
Fax
(602) 957-2263
NPI assigned
Apr 7, 2006
Last updated
Jun 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5590 AZ Primary

Addresses

Primary practice location

4214 E Indian School Rd
Ste 102
Phoenix, AZ 85018-5337

Mailing address

4214 E Indian School Rd
Ste 102
Phoenix, AZ 85018-5337
Phone (602) 957-2170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160926001568 AZ Order and Referring Only - DentistPractitioner - Dentist 2466749064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5590AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Milana DDS PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339200000000",
    "number": "1730142118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 E INDIAN SCHOOL RD",
            "address_2": "STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185337",
            "telephone_number": "602-957-2170",
            "fax_number": "602-957-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 E INDIAN SCHOOL RD",
            "address_2": "STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185337",
            "telephone_number": "602-957-2170",
            "fax_number": "602-957-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANA",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2012-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.