DR. COLETTA M MILLER


Address: 3740 E Lake Ctr, Quincy, IL 62305-5805
Phone: 2172246789

DR. COLETTA M MILLER (NPI# 1760488514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760488514
Entity Type Individual
Full Name DR. COLETTA M MILLER
Credential D.D.S.
Practice Address 3740 E Lake Ctr
Quincy
IL 62305-5805
Practice Telephone 2172246789
Practice Fax Number 2172249675
Mailing Telephone 2172246789
Mailing Fax Number 2172249675
Enumeration Date 2005-06-27
Last Update Date 2010-08-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
021-001383 IL Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
IA 0589937 05
IL 102687 05

Office Location

Street Address 3740 E LAKE CTR
City QUINCY
State IL
Zip Code 62305-5805

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578915260 Sara Rodeffer Dentist 3740 E Lake Ctr, Suite B, Quincy, IL 62305-5805 2016-07-06
1740667849 Midwest Orthopedic Specialists Inc Chiropractor 3740 E Lake Ctr, Quincy, IL 62305-5805 2015-04-28
1023231693 Midwest Foot and Ankle Specialists PC Podiatrist 3740 E Lake Ctr, Quincy, IL 62305-5805 2007-04-11
1043335292 Janet Elaine Martin Dentist 3740 E Lake Ctr, Suite B, Quincy, IL 62305-5805 2007-03-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386999001 Kristi Michelle Gillette Internal Medicine 5011 Oak St, Quincy, IL 62305 2012-07-18
1447582549 Cathi Marie Webb Counselor 3701 E Lake Center Dr, Suite # 8 The Shaw Building, Quincy, IL 62305 2010-02-01
1285804450 Curtis D Fauble Dentist 4561 Maine, Quincy, IL 62305 2008-03-04
1598940256 Kelley Jo Begeman Licensed Practical Nurse 934 North 1903 Road Lane, Quincy, IL 62305 2007-12-31
1649459470 Aa Dental Care PC Dentist 407 So 48th Street, Quincy, IL 62305 2007-10-29
1982803920 Dennis Ryan Wagner Dentist 407 South 48th St, Quincy, IL 62305 2007-07-11
1689899056 Capelle House Day Training, Developmentally Disabled Services 3325 Ghost Hollow Road, Quincy, IL 62305 2007-04-13
1750416236 Julie A Danker Social Worker 2209 N 64th St, Quincy, IL 62305 2007-02-23
1942812300 Brooke N Bracy Dentist 4561 Maine, Quincy, IL 62305 2020-08-18
1558997379 Blessing Corporate Services, Inc Clinic/Center 4800 Maine St, Quincy, IL 62305 2020-03-13
Find all providers in zip 62305

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447212972 David Paul Lustbader Dentist 270 Quincy Ave, Quincy, MA 02169-8127 2006-04-03
1861803967 Michael Robert Shemkus Dentist 270 Quincy Ave, Quincy, MA 02169-8127 2014-05-13
1316120033 Quincy Oral & Maxillofacial Surgery, P.C. Dentist 3915 Maine St, Suite 3, Quincy, IL 62305-5843 2007-12-17
1053462358 South Shore Oral Surgery Associates Co. Inc. Dentist 270 Quincy Ave, Quincy, MA 02169-8127 2007-01-15
1760533061 Michael H Gu Dentist 270 Quincy Ave, Quincy, MA 02169-8127 2007-01-15
1548341191 Daniel E Riggs Dentist 3915 Maine St, Suite 3, Quincy, IL 62305-5843 2006-10-18
1548290653 Robert Edward Garber Dentist 500 Congress St, Suite 3-d, Quincy, MA 02169-0908 2006-07-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255986576 Othman Rezki Dentist 1900 W Polk St # 611, Chicago, IL 60612-3723 2019-08-04
1215410584 David Peterson Dentist 1619 Brandywine Ln, Dixon, IL 61021-8757 2018-09-12
1952887374 Winnebago Braces, LLC. Dentist 555 N Court St Ste 110, Rockford, IL 61103-6898 2018-07-18
1093232951 Robert C. Bosack, Dds & Associates, Ltd Dentist 16011 108th Ave Ste A, Orland Park, IL 60467-8787 2017-08-23
1790146132 Family Millennium Dentistry, Inc. Dentist 1342 W Randolph St, Chicago, IL 60607-1522 2016-03-13
1770962375 Eunsu Jung Dentist 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 2015-05-28
1811374945 Alexandria Hawkins Dentist 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 2015-04-27
1043607872 Alissa Nicole Pullos Dentist 105 E 1st St Ste 103, Hinsdale, IL 60521 2015-04-20
1538592654 Matthew Seena Hamedani Dentist 3116 Oak Park Ave, Berwyn, IL 60402 2013-08-13
1578907689 M Timothy Murphy Dentist 500 Davis St Ste 509, Evanston, IL 60201-4621 2013-04-18
Find all providers with the same taxonomy

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City QUINCY
Zip Code 62305

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Dataset Information

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.

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