Orthodontics & Pediatric Assoc of Commack

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

048254 Issued in NY

Legal business name

ORTHODONTICS & PEDIATRIC ASSOC OF COMMACK

Practice address

164 Commack Rd
Ste 4
Commack, NY 11725

Phone

(631) 499-3377

Fax

(631) 858-0586

NPI assigned

Sep 18, 2008

Last updated

Sep 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Monte D. Miller, DMD

Title

Dentist/Partner

Phone

(631) 499-2112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1760631402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 COMMACK RD",
            "address_2": "STE 4",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-499-3377",
            "fax_number": "631-858-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 COMMACK RD",
            "address_2": "STE 4",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-499-3377",
            "fax_number": "631-858-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTICS & PEDIATRIC ASSOC OF COMMACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MONTE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DENTIST/PARTNER",
        "authorized_official_telephone_number": "631-499-2112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "048254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Commack, NY
• Providers in Commack, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.