RODERICK E MCMILLEN DDS A DENTAL CORP (NPI# 1215037684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215037684 |
| Entity Type | Organization |
| Organization Name | RODERICK E MCMILLEN DDS A DENTAL CORP |
| Practice Address |
825 Sequoia Circle Fort Bragg CA 95347 |
| Practice Telephone | 7079640242 |
| Practice Fax Number | 7079640244 |
| Mailing Telephone | 7079640242 |
| Mailing Fax Number | 7079640244 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RODERICK E MCMILLEN (PRESIDENT OF SMALL CORP) |
| Authorized Official Telephone | 7079640242 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
18587 | CA | Dental Providers |
| Street Address |
825 SEQUOIA CIRCLE |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457503310 | Roderick E. Mcmillen Jr. | Dentist | 825 Sequoia Circle, Fort Bragg, CA 95437-5422 | 2008-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574670 | Rodney Saunders | Nurse Practitioner | 4527 Bastogne Dr, Fort Bragg, NC 28310-0001 | 2020-10-02 |
| 1750997110 | William James Graham Iv | Dentist | Bldg B-6837 Normandy Dr, Fort Bragg, NC 28310-0001 | 2020-09-21 |
| 1700498631 | Jaclyn Jennifer Willis | Dentist | Ardennes Street, Fort Bragg, NC 28307 | 2020-08-21 |
| 1487265039 | John Michael Mckelvey Jr. | Dentist | 6238 Ardennes St, Fort Bragg, NC 28310-0001 | 2020-08-16 |
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1992313084 | Happy Rides LLC | Non-emergency Medical Transport (VAN) | 26577 N Highway 1, Fort Bragg, CA 95437-9586 | 2020-07-15 |
| 1477179869 | Stephen Aaron Reid | Physician Assistant | Robinson Clinic, 1722 Tagatay Dr, Fort Bragg, NC 23807 | 2020-06-22 |
| 1558987933 | Robert Faulk | Physical Therapist | 3rd Special Forces Group 111 Enduring Freedom Drive, Fort Bragg, NC 28310-0001 | 2020-06-22 |
| 1053933291 | Maureen Smyth | Registered Nurse | 1025 E Chestnut St, Fort Bragg, CA 95437-5004 | 2020-05-11 |
| 1679194906 | Jeff Bertheola | Dentist | 825 Sequoia Cir, Fort Bragg, CA 95437-5422 | 2020-04-27 |
| Find all providers in FORT BRAGG | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997110 | William James Graham Iv | Dentist | Bldg B-6837 Normandy Dr, Fort Bragg, NC 28310-0001 | 2020-09-21 |
| 1679194906 | Jeff Bertheola | Dentist | 825 Sequoia Cir, Fort Bragg, CA 95437-5422 | 2020-04-27 |
| 1114572229 | Amanda C Blankenship | Dentist | Smoke Bomb Hill Dental Clinic 3817 Gruber Rd, Fort Bragg, NC 28310-0001 | 2019-08-06 |
| 1831754795 | Ryan David Smith | Dentist | Bldg 4681 Logistics Ave, Fort Bragg, NC 28310-0001 | 2019-05-07 |
| 1588159263 | Jenniffer Rendon-velasquez | Dentist | 3817 Gruber Rd, Fort Bragg, NC 28310-8925 | 2018-06-26 |
| 1912423377 | Lejla Streets | Dentist | 2827 Reilly Rd, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| 1033635420 | Andrew Seun | Dentist | Bldg 6837 Normandy Drive, Fort Bragg, NC 28310-0001 | 2017-08-17 |
| 1184144479 | Thomas William Hanna IIi | Dentist | Bldg C-6238 Ardennes St., Fort Bragg, NC 28307 | 2017-06-27 |
| 1598134769 | Sidney Choi | Dentist | 499 E Chestnut St, Fort Bragg, CA 95437-4913 | 2015-09-17 |
| 1083048706 | Gamal Ahmad Baker | Dentist | Logisitcs Ave Bldg M-4861, Us Army Dental Activity, Fort Bragg, NC 28310-7302 | 2013-08-29 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95347 |
Please comment or provide details below to improve the information on RODERICK E MCMILLEN DDS A DENTAL CORP.
| 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.