Organization Active NPI

South Hill Childrens Dentistry

  • Pediatric Dentistry
  • Puyallup, WA
National Provider Identifier
1821159047
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6837 Issued in WA
Legal business name
SOUTH HILL CHILDRENS DENTISTRY
Practice address
11102 Sunrise Blvd E
Suite 108
Puyallup, WA 98374-8846
Phone
(253) 848-1022
Fax
(253) 848-0218
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James L Miller, DDSNPI 1992936199
Title
Owner
Phone
(253) 848-1022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 6837 WA Primary

Addresses

Primary practice location

11102 Sunrise Blvd E
Suite 108
Puyallup, WA 98374-8846

Mailing address

11102 Sunrise Blvd
Suite 108
Puyallup, WA 98374-8846
Phone (253) 848-1022

National Provider Directory

National Provider Directory

Locations

11102 Sunrise Blvd E
Ste 108
Puyallup, WA 98374
Phone (253) 209-7555

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821159047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD",
            "address_2": "SUITE 108",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748846",
            "telephone_number": "253-848-1022",
            "fax_number": "253-848-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E",
            "address_2": "SUITE 108",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748846",
            "telephone_number": "253-848-1022",
            "fax_number": "253-848-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HILL CHILDRENS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-848-1022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "6837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.