Active NPI
Tom Terry Milliken III, DDS
- General Practice Dentistry
- Vidalia, LA
National Provider Identifier
1932335965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5976
- Practice address
- 202 Advocate Row
Vidalia, LA 71373 - Phone
- (318) 757-3648
- Fax
- (318) 757-9370
- NPI assigned
- Jun 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5976 | LA | Primary |
Addresses
Primary practice location
202 Advocate Row
Vidalia, LA 71373
Mailing address
202 Advocate Row
Vidalia, LA 71373
Phone (318) 757-3648
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5976 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jim Iverstine, D.D.S., Apc | General Practice | Past | Accepting new patients |
| Miss-Lou Dental LLC | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Ferriday, LA
- NPI 1417250382
-
- General Practice Dentistry
- Natchez, MS
- NPI 1760818017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1932335965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 ADVOCATE ROW",
"city": "VIDALIA",
"state": "LA",
"postal_code": "71373",
"telephone_number": "318-757-3648",
"fax_number": "318-757-9370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 ADVOCATE ROW",
"city": "VIDALIA",
"state": "LA",
"postal_code": "71373",
"telephone_number": "318-757-3648",
"fax_number": "318-757-9370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLIKEN",
"first_name": "TOM",
"middle_name": "TERRY",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-04",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "5976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vidalia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.