Individual provider Active NPI

Robert Miller, D.D.S.

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1932201688
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9395 Issued in SC
Practice address
1149 Savannah Hwy Ste 305
Charleston, SC 29407-7819
Phone
(843) 213-6881
Fax
(843) 277-1971
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9395 SC Primary
General Practice Dentistry 1223G0001X 9395 IL

Addresses

Primary practice location

1149 Savannah Hwy Ste 305
Charleston, SC 29407-7819

Mailing address

480 Briargate Dr
South Elgin, IL 60177-2225
Phone (847) 841-1818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250816000224 TX Order and Referring Only - DentistPractitioner - Dentist 8123527173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9395ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of West Ashley, PC General Practice CurrentSince Mar 20, 2025 Accepting new patients
Revolution Dental Past Accepting new patients

Locations

1149 Savannah Hwy
Ste 305
Charleston, SC 29407
Phone (440) 479-5285

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1932201688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BRIARGATE DR",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601772225",
            "telephone_number": "847-841-1818",
            "fax_number": "847-301-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 SAVANNAH HWY STE 305",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077819",
            "telephone_number": "843-213-6881",
            "fax_number": "843-277-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9395",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "9395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.