DR. JACK J. MILLER (NPI# 1598830465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598830465 |
| Entity Type | Individual |
| Full Name | DR. JACK J. MILLER |
| Credential | D.D.S. |
| Practice Address |
3716 Pontoon Rd Granite City IL 62040-4252 |
| Mailing Address |
237 Park Dr Edwardsville IL 62025-4230 |
| Practice Telephone | 6189316800 |
| Mailing Telephone | 6186562153 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528444304 | Jack Miller | Pharmacist | 1262 S. Conwell Stc, Casper, WY 82601 | 2015-08-04 |
| 1396127569 | Jack Parker Miller Jr. | Family Medicine | 2000 E Greenville St Ste 3600, Anmed Health Family Medicine Residency Prog., Anderson, SC 29621-1725 | 2015-06-24 |
| 1407130198 | Jack Lawrence Miller | Massage Therapist | 7620 N Hartman Ln Ste 184, Tucson, AZ 85743-7485 | 2011-09-29 |
| 1619274867 | Jack Glenn Miller | Naturopath | 1308 N Stockton Hill Rd Ste A-153, Kingman, AZ 86401-5139 | 2011-02-24 |
| 1033350889 | Jack M. Miller | Obstetrics & Gynecology | 6406 E 108th St, Tulsa, OK 74137-8907 | 2009-03-07 |
| 1073770764 | Jack Randolph Miller | Dentist | 2078 Ne Professional Ct, Bend, OR 97701-6077 | 2008-05-20 |
| 1801912191 | Jack L Miller | Preventive Medicine | 220 Cobb Pkwy N, Suite 400, Marietta, GA 30062-3581 | 2007-03-21 |
| 1245377589 | Jack A Miller | Psychiatry & Neurology | 384 West Rd, Alford, MA 01266-9756 | 2007-01-30 |
| 1497824627 | Jack Edwin Miller | Psychiatry & Neurology | 765 Baywood Dr, #231, Petaluma, CA 94954 | 2006-11-06 |
| 1942288949 | Jack W. Miller | Dentist | 2203 Sweetbriar St, Wichita, KS 67204-5518 | 2006-01-09 |
| Street Address |
3716 PONTOON RD |
| City | GRANITE CITY |
| State | IL |
| Zip Code | 62040-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982769964 | Roger Michael Mueller | Dentist | 3716 Pontoon Rd, Granite City, IL 62040-4252 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043736705 | Christine S Bieniecki Canada | Speech-Language Pathologist | 2300 West 25th St, Granite City, IL 62040 | 2017-08-15 |
| 1881085819 | James Watson | Counselor | 50 Northgate Industrial Drive, Granite City, IL 62040 | 2015-02-12 |
| 1518208719 | Chestnut Health Systems | Clinic/Center | 110 Northagte Industrial Drive, Granite City, IL 62040 | 2013-03-13 |
| 1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
| 1427360502 | Erin K Boerm | Occupational Therapist | 3540 Village Lane, Granite City, IL 62040 | 2010-07-06 |
| 1659503027 | Toni Lyn Siler | Counselor | 101 Whitsell Way, Apt 102, Pontoon Beach, IL 62040 | 2009-08-18 |
| 1871741462 | Fountain View Manor LLC | Alzheimer Center (Dementia Center) | 3432 Village Lane, Granite City, IL 62040 | 2008-09-08 |
| 1083880595 | Christina Marie Darin | Chiropractor | 2013 Johnson Road, Suite C & D, Granite City, IL 62040 | 2008-05-05 |
| 1629244322 | Julia Elaine Uhring Green | Counselor | 2429 Washinton Ave, Granite City, IL 62040 | 2008-05-02 |
| 1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
| Find all providers in zip 62040 | ||||
| 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 |
|---|---|---|---|---|
| 1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
| 1841339686 | Kent Joseph Splaingard | Dentist | 1923 Johnson Rd, Granite City, IL 62040-3845 | 2007-02-06 |
| 1487726857 | Donna Kay Porterfield | Dentist | 2161 Pontoon Rd, Granite City, IL 62040-4015 | 2006-11-14 |
| 1447331129 | Jan M Mehelic | Dentist | 3949 State Route 111, Granite City, IL 62040-4302 | 2006-10-18 |
| 1932294212 | David J Dombek | Dentist | 125 Riviera Dr, Granite City, IL 62040-4120 | 2006-10-04 |
| 1295828382 | Dipali D Thakker | Dentist | 3429 Nameoki Rd, Granite City, IL 62040-3709 | 2006-10-02 |
| 1700984317 | Stacy Renae Moody | Dentist | 3120 Maryville Rd, Granite City, IL 62040-5189 | 2006-09-20 |
| 1134234636 | David Alan Diak | Dentist | 1911 Johnson Rd, Suite # 1, Granite City, IL 62040-3835 | 2006-08-21 |
| 1427162247 | Philip S Valicoff | Dentist | 3723 Nameoki Rd Stop 1, Granite City, IL 62040-3721 | 2006-08-18 |
| 1710955968 | Mark Thomas Hewlett | Dentist | 2101 Pontoon Rd, Granite City, IL 62040-4015 | 2006-03-12 |
| Find all providers in GRANITE CITY | ||||
| City | GRANITE CITY |
| Zip Code | 62040 |
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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.