Active NPI
Sukari J McMiller, DDS
- General Practice Dentistry
- Conyers, GA
National Provider Identifier
1841506094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN013186
- 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, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DN013186 | GA | MD | General 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.