Gregory Paul Miller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9218 Issued in MN

Practice address

1140 South Ave
North Mankato, MN 56003-3533

Phone

(507) 345-5464

NPI assigned

Feb 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 26, 2012 through Jun 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790811180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 SOUTH AVE",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560033533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SOUTH AVE",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560033533",
            "telephone_number": "507-345-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D9218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "D9218",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy L McQuown-Pech, BSN, RN
• Mecca Health Epicenter, LLC
• Kamar Yussuf Megag
• Maxamillion Anthony Mettler, DC, DPHCS
• Megan Ann Mettler, D.C.
• James Andrew Miller, MD
• Geneva Morales
• Madisyn Morrow, OTD, OTR/L
• Kylie Sue Morton
• Marissa Laurel Murphey

• General Practice Dentistry in North Mankato, MN
• Providers in North Mankato, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.