Individual provider Active NPI

Joseph L Miller, D.D.S., P.A.

  • Oral and Maxillofacial Surgery (Dentist)
  • Greensboro, NC
National Provider Identifier
1891724431
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4728 Issued in NC
Practice address
3824 N Elm St
Suite 209
Greensboro, NC 27455-2596
Phone
(336) 282-7475
Fax
(336) 282-7929
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4728 NC Primary

Addresses

Primary practice location

3824 N Elm St
Suite 209
Greensboro, NC 27455-2596

Mailing address

3824 N Elm St
Suite 209
Greensboro, NC 27455-2596
Phone (336) 282-7475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614001528 NC Practitioner - Maxillofacial SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 4284618752 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4728NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince May 8, 2023 Accepting new patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince May 8, 2023 Accepting new patients
Justin L Drab, DMD, PA CurrentSince Apr 1, 2004 Accepting new patients
Shenan Bradshaw DDS MD PA Oral and Maxillofacial Surgery PastSince Feb 15, 2005 Accepting new patients
Shenan Bradshaw DDS MD PA Past Accepting new patients

Locations

3824 N Elm St
Ste 209
Greensboro, NC 27455
Phone (336) 282-7475

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1891724431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552596",
            "telephone_number": "336-282-7475",
            "fax_number": "336-282-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552596",
            "telephone_number": "336-282-7475",
            "fax_number": "336-282-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "4728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.