Individual provider Active NPI

Sukari J McMiller, DDS

  • General Practice Dentistry
  • Conyers, GA
National Provider Identifier
1841506094
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013186 Issued in GA
Practice address
1806 Over Lake Dr SE
Conyers, GA 30013-1745
Phone
(770) 760-7900
Fax
(770) 760-1375
NPI assigned
Aug 26, 2010
Last updated
Aug 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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 DN013186 GA Primary

Addresses

Primary practice location

1806 Over Lake Dr SE
Conyers, GA 30013-1745

Mailing address

8909 Brandy Rose
Douglasville, GA 30134-1667
Phone (770) 760-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN013186GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1841506094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 BRANDY ROSE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341667",
            "telephone_number": "770-760-7900",
            "fax_number": "770-760-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 OVER LAKE DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131745",
            "telephone_number": "770-760-7900",
            "fax_number": "770-760-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLER",
        "first_name": "SUKARI",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.