DR. MARK D. MILLER (NPI# 1104982016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104982016 |
| Entity Type | Individual |
| Full Name | DR. MARK D. MILLER |
| Credential | DDS |
| Practice Address |
1211 W Broadway Unit 106 Louisville KY 40203-2082 |
| Mailing Address |
15142 Rosario Rd Frisco TX 75035-5439 |
| Practice Telephone | 2708850165 |
| Practice Fax Number | 2708862224 |
| Mailing Telephone | 2708893686 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
36087 | TX | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6861 | KY | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 6861 | KY | Allopathic & Osteopathic Physicians |
| N | 1223D0004X |
Dentist Specialization: Dentist Anesthesiologist |
6861 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60068616 | 05 | |
| KY | 64068612 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2400 Richmond Rd Ste 133, Texarkana, TX 755032464 | 9033060790 | 9038319940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932731692 | Mark A Miller | Pharmacist | 5431 Sw 35th Dr Ste 200, Gainesville, FL 32608-5277 | 2020-02-10 |
| 1386111250 | Mark Miller | Counselor | 3605 Calumet St, Philadelphia, PA 19129-1603 | 2018-10-30 |
| 1386124873 | Mark E Miller | Dentist | 558 E Bay Ave, Manahawkin, NJ 08050-3340 | 2018-08-15 |
| 1326536335 | Mark Jay Miller | Technician/Technologist | 3617 Sipler Ln, Huntingdon Valley, PA 19006-3223 | 2018-04-25 |
| 1801264148 | Mark J Miller | Counselor | 4141 Highway 11, Rising Fawn, GA 30738-4633 | 2015-09-03 |
| 1427317197 | Mark Anthony Miller | Physical Therapist | 537 West Main St, Brewster, WA 98812-1200 | 2012-05-15 |
| 1790044428 | Mark Ian Miller | Student in an Organized Health Care Education/Training Program | 843 S Sierra Bonita Ave, Los Angeles, CA 90036-4703 | 2012-05-15 |
| 1023384989 | Mark H Miller | Internal Medicine | 6318 17th Ave Ne, Seattle, WA 98115-6809 | 2012-03-26 |
| 1649578816 | Mark A Miller | Pharmacist | 8 Elk Plz, Elkview, WV 25071-9602 | 2011-03-11 |
| 1538399753 | Mark E Miller | Social Worker | 645 S 5th St, Montrose, CO 81401-5710 | 2009-07-22 |
| Street Address |
1211 W BROADWAY UNIT 106 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40203-2082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619407053 | Shmuel Dabush | Dentist | 1211 W Broadway Unit 106, Louisville, KY 40203-2082 | 2017-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211738 | Integrated Health Systems LLC | Psychiatry & Neurology | 645 S Roy Wilkins Ave Ste 300, Louisville, KY 40203 | 2018-07-18 |
| 1104317734 | Usimc of West Virginia Medical Corporation | Clinic/Center | 908 W Broadway Fl 8, Louisville, KY 40203 | 2018-05-18 |
| 1699296293 | Jennifer Christine Angermeier | Nurse Practitioner | 1130 W Chestnut St, Louisville, KY 40203 | 2017-07-05 |
| 1083162812 | Deloris Jean Johnson | Social Worker | 1022 South 6th Street, Louisville, KY 40203 | 2016-09-21 |
| 1770978512 | Michael Bricken | Pediatrics | 760 S Hancock St # B100, Louisville, KY 40203 | 2015-03-30 |
| 1770906885 | Jason Scott Underhill | Counselor | 214 E Breckinridge St, Louisville, KY 40203 | 2014-01-24 |
| 1316372592 | Tonya Alicia Clay | Marriage & Family Therapist | 1000 South 5th Street, Family & Children's Place, Louisville, KY 40203 | 2013-09-06 |
| 1780929216 | Harambee Health Center, Inc | Clinic/Center | 800 South Preston St., Louisville, KY 40203 | 2012-12-10 |
| 1083977276 | Synergy Rehabilitation, Inc. | Physical Therapist | 832 S. 6th Street, Suite C, Louisville, KY 40203 | 2012-06-21 |
| 1043572803 | Sonya Helen Mitchell | Counselor | 2225 W. Broadway, Louisville, KY 40203 | 2012-06-07 |
| Find all providers in zip 40203 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1922361062 | Alan Reisman, Dds, PC | Dentist | 1075 S Boulder Rd Ste 135, Louisville, CO 80027-2559 | 2012-06-22 |
| 1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
| 1033372057 | Lawrence Sivori II | Dentist | 3101 Breckenridge Ln Ste 2d, Louisville, KY 40220-2742 | 2008-07-09 |
| 1790944106 | David Naselsker | Dentist | 3421 Hycliffe Ave, Louisville, KY 40207-3659 | 2008-06-02 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1730382722 | Lewis C. Jones | Dentist | 401 E Chestnut St Unit 550, Louisville, KY 40202-5705 | 2007-06-07 |
| 1285709865 | David T Dodd | Dentist | 4122 Shelbyville Rd Ste 120, Louisville, KY 40207-3206 | 2006-11-21 |
| 1306933387 | Alan Jon Reisman | Dentist | 1075 E South Boulder Rd, Suite 230, Louisville, CO 80027-2560 | 2006-10-09 |
| 1285731836 | Steven W Cherry | Dentist | 6520 Glenridge Park Pl, Suite 7, Louisville, KY 40222-3453 | 2006-09-17 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40203 |
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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.