Individual provider Active NPI

John William Miller, D.D.S.

  • General Practice Dentistry
  • Boswell, PA
National Provider Identifier
1851482962
Registry record updated Feb 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027489L Issued in PA
Practice address
403 Main St
Boswell, PA 15531-1116
Phone
(814) 629-5603
NPI assigned
Sep 27, 2006
Last updated
Feb 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2016

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 DS027489L PA Primary

Addresses

Primary practice location

403 Main St
Boswell, PA 15531-1116

Mailing address

403 Main St
Boswell, PA 15531-1116
Phone (814) 629-5603

Other identifiers 1

IdentifierTypeStateIssuer
0017746060001OtherPACOMMONWEALTH PA ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207000696 PA Order and Referring Only - DentistPractitioner - Dentist 2163716572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boswell Dental Center, Inc General Practice Past Accepting new patients
Boswell Dental Clinic General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454803200000",
    "number": "1851482962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "BOSWELL",
            "state": "PA",
            "postal_code": "155311116",
            "telephone_number": "814-629-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "BOSWELL",
            "state": "PA",
            "postal_code": "155311116",
            "telephone_number": "814-629-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027489L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH PA ID#",
            "identifier": "0017746060001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boswell, PA

Sources for this page

Verify at the official NPI Registry.