Individual provider Active NPI

Blaine Glen Milne, DMD

  • General Practice Dentistry
  • Orem, UT
National Provider Identifier
1750422804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5076480-9922 Issued in UT
Practice address
1834 S State St
Orem, UT 84097-8109
Phone
(801) 224-0222
Fax
(801) 226-7560
NPI assigned
Feb 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5076480-9922 UT Primary

Addresses

Primary practice location

1834 S State St
Orem, UT 84097-8109

Mailing address

1834 S State St
Orem, UT 84097-8109
Phone (801) 224-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20161004002631 NM Order and Referring Only - DentistPractitioner - Dentist 1456649623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5076480-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750422804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840978109",
            "telephone_number": "801-224-0222",
            "fax_number": "801-226-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840978109",
            "telephone_number": "801-224-0222",
            "fax_number": "801-226-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILNE",
        "first_name": "BLAINE",
        "middle_name": "GLEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5076480-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.