Marissa L Miller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.022851 Issued in OH

Practice address

3874 Burbank Road
Wooster,, OH 44691

Phone

(330) 262-8383

Fax

(330) 345-5223

NPI assigned

Jul 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Third Street Community Clinic, Inc

  • Community/Retail Pharmacy
  • Mansfield, OH
  • NPI 1497485973
  NPD (past)
• William a Fischer III DDS, PC , Inc.

  • General Practice Dentistry
  • Wooster, OH
  • NPI 1518199041
  NPD (past)

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1952566986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13220",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 BURBANK ROAD",
            "city": "WOOSTER,",
            "state": "OH",
            "postal_code": "44691",
            "telephone_number": "330-262-8383",
            "fax_number": "330-345-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.022851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Miller
• Jordon K Miller, EMT-P
• Kailey Miller
• Logan Miller, BA, LSW
• Louise A Miller, M.D.
• Megan Miller
• Melisa D Miller, LPC
• Michael E Miller, DDS
• Rachelle Miller, SWT
• Raquel E Miller

• General Practice Dentistry in Wooster,, OH
• Providers in Wooster,, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.