Individual provider Active NPI

Luis Felipe Miranda, D.M.D.

  • Dentist
  • Princeton, KY
National Provider Identifier
1902238496
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10243 Issued in KY
Practice address
406 W Washington St
Princeton, KY 42445
Phone
(270) 365-7244
NPI assigned
Aug 6, 2013
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10243 KY Primary

Addresses

Primary practice location

406 W Washington St
Princeton, KY 42445

Mailing address

406 W Washington St
Princeton, KY 42445-1938
Phone (270) 365-7244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200824002477 KY Order and Referring Only - DentistPractitioner - Dentist 5991019291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10243KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Miranda Dental, PLLC CurrentSince Jan 29, 2023 Accepting new patients
James J. Swick, II, D.D.S., PA Past Accepting new patients

Locations

406 W Washington St
Princeton, KY 42445
Phone (270) 365-7244

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1902238496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W WASHINGTON ST",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "424451938",
            "telephone_number": "270-365-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W WASHINGTON ST",
            "city": "PRINCETON",
            "state": "KY",
            "postal_code": "42445",
            "telephone_number": "270-365-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "LUIS",
        "middle_name": "FELIPE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-06",
        "last_updated": "2023-01-23",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, KY

Sources for this page

Verify at the official NPI Registry.