Individual provider Active NPI

Collin Miller

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1861109589
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
063924 Issued in NY
Practice address
760 Broadway
Brooklyn, NY 11206-5317
Phone
(716) 984-0263
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 063924 NY Primary

Addresses

Primary practice location

760 Broadway
Brooklyn, NY 11206-5317

Mailing address

192 Seneca St
Buffalo, NY 14204-2073

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

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1861109589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 SENECA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142042073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "716-984-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.