Miller Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MILLER DENTAL PLLC

Practice address

3307 Miller Ave Suite #a
Fort Worth, TX 76119

Phone

(817) 413-6000

Fax

(817) 413-6000

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Phuong DONPI 1417171281

Title

Owner

Phone

(817) 413-6000

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miller Dental & Orthodontics Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phuong Kim DO, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Dallas, TX
  • NPI 1417171281

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1730699802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 MILLER AVE STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761191971",
            "telephone_number": "817-413-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 MILLER AVE SUITE #A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76119",
            "telephone_number": "817-413-6000",
            "fax_number": "817-413-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-413-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22079",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272246221",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miller Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Biljana Miljatovic, PHARMD
• Phillip Millan, PTA
• Millard L Tierce IV DO
• Stacy Millen, PTA
• Miller Dental
• Aaron Miller, PT, DPT, FAAOMPT
• Alison J Miller, PT
• Amanda Rae Miller, APRN, FNP-C
• Andrew Louis Miller, M.D.
• Angela Rae Miller, MSN, RN, CPNP-PC

• Dental Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.