DR. MATTHEW BRADEN BURNS MILLER (NPI# 1043207004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043207004 |
Entity Type | Individual |
Full Name | DR. MATTHEW BRADEN BURNS MILLER |
Credential | DDS |
Practice Address |
1 Wahoo Ave Groton CT 06349 |
Mailing Address |
12 Somerset Ln Old Lyme CT 06371-1737 |
Practice Telephone | 8606943094 |
Mailing Telephone | 3017754866 |
Enumeration Date | 2005-10-04 |
Last Update Date | 2019-10-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223G0001X |
Dentist Specialization: General Practice |
DE00009227 | WA | Dental Providers |
Y | 1223P0300X |
Dentist Specialization: Periodontics |
12339 | CT | Dental Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1253 Makalapa Gate Rd, Pearl Harbor, HI 968604479 | 8084730495 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
1598386385 | Matthew Ryan Miller | Registered Nurse | 711 Spring St, Santa Barbara, CA 93103-2407 | 2020-05-03 |
1366087082 | Matthew D Miller | Physician Assistant | 506 5th Ave Ste 2ff, Brooklyn, NY 11215-4812 | 2019-11-18 |
1447728951 | Matthew David Miller | Student in an Organized Health Care Education/Training Program | 5369 E 50 S, Lagro, IN 46941-9434 | 2018-11-02 |
1932686961 | Matthew Thomas Miller | Chiropractor | 4791 Calle Real Ste 103, Santa Barbara, CA 93110-1308 | 2018-07-23 |
1538682364 | Matthew Miller | Counselor | 3700 Willow Creek Rd Bldg 73, Prescott, AZ 86301-3721 | 2017-07-24 |
1326435215 | Matthew W Miller | Otolaryngology | 981225 University of Nebraska Medical Ctr, Omaha, NE 68198-1225 | 2015-04-19 |
1801216841 | Matthew Cameron Miller | Specialist/Technologist | 7715 Waterford Lakes Dr, Apt 3036, Charlotte, NC 28210-7414 | 2014-04-17 |
1649520933 | Matthew S Miller | Dentist | 51 Mdg/ds, Unit 2060, Apo, AA 96278-2060 | 2012-09-13 |
1285980581 | Matthew Stephen Miller | Pharmacist | 3791 Richardson Rd, Scotts Mills, OR 97375-9616 | 2012-07-24 |
Street Address |
1 WAHOO AVE |
City | GROTON |
State | CT |
Zip Code | 06349 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
1770112708 | Amanda Kathleen Dobyns | Occupational Therapist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-04-02 |
1831732825 | Cody Clark | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-10-22 |
1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
1699335372 | Cynthia Daigneault | Counselor | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-06-16 |
1942868211 | Cameron Anson Martin | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340 | 2019-06-03 |
1104386903 | Zena Sabath | General Practice | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-03-20 |
1538636527 | Winston Eugene Young | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-27 |
1811462096 | Howard E Pratt | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
1588127575 | Morgan Ross Jones | Student in an Organized Health Care Education/Training Program | Bx 159 Navsubase Nlon, Groton, CT 06349 | 2019-04-08 |
1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
1013264423 | Dennis Buenaventura Custodio | Military Health Care Provider | 69 Trout Ave, Naval Undersea Medical Institute, Groton, CT 06349 | 2012-08-06 |
1609013549 | Nicolas David Mendoza | Military Health Care Provider | Uss Hawaii (ssn 776), Fpo, AE 06349 | 2009-01-14 |
1881843084 | Mark Francis Jarvis | Military Health Care Provider | Nssc Nlon, Bldg 76, Groton, CT 06349 | 2008-09-11 |
1780882738 | Michael Nutt | Military Health Care Provider | Bldg 517 Taugtog Ave, Navsubscol, Groton, CT 06349 | 2007-07-10 |
1497811343 | Keith Benjamin Hoekman | Nurse Practitioner | 1 Wahoo Dr, Groton, CT 06349 | 2006-12-28 |
1881604163 | Christina E Toufexis | Pediatrics | 1 Wahoo Drive, Groton, CT 06349 | 2006-08-09 |
Find all providers in zip 06349 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851562466 | Arthur Fred Dean | Dentist | 489 Route 184, Suite 201, Groton, CT 06340-6227 | 2008-03-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699384966 | Connecticut Periodontal & Implant Associates | Dentist | 1080 Day Hill Rd Ste 101, Windsor, CT 06095-1781 | 2020-07-23 |
1790212348 | Vidushi Gupta | Dentist | 546 S Broad St Ste 2d, Meriden, CT 06450-6601 | 2017-05-15 |
1184057192 | Hamden Family Dental Center | Dentist | 4193 Whitney Ave, Hamden, CT 06518-1212 | 2013-08-13 |
1649618901 | Avon Center Dentistry | Dentist | 19 Ensign Drive, Avon, CT 06001 | 2013-06-10 |
1487900528 | Amazing Smiles LLC | Dentist | 148 East Ave Ste 1b, Norwalk, CT 06851-5727 | 2012-07-26 |
1851614002 | Patricia I Diaz-moreno | Dentist | 263 Farmington Ave # Mc2820, Farmington, CT 06030-2820 | 2010-03-02 |
1003045675 | Sejal Thacker | Dentist | 82 Spring Lane, West Hartford, CT 06107 | 2009-07-04 |
1013144039 | Stella L. Laskowski | Dentist | 74 Palomba Drive, Enfield, CT 06082 | 2009-06-17 |
1407019557 | Nicole Ann Marquis | Dentist | 51 Boston Post Rd, Suite 10, Madison, CT 06443-2155 | 2008-07-09 |
1811171150 | Lawrence Delibero | Dentist | 17 1/2 Elm St, New Canaan, CT 06840-5502 | 2007-12-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.