Provider Demographics
NPI:1730345737
Name:MILLER, JENNIFER JOAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JOAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6193 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9000
Mailing Address - Country:US
Mailing Address - Phone:614-580-6079
Mailing Address - Fax:
Practice Address - Street 1:106 NORTH HIGH ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017
Practice Address - Country:US
Practice Address - Phone:614-580-6079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539381223G0001X
OH30.0228901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice