Provider Demographics
NPI:1861518532
Name:JAMES T. MCMILLIN DDS, INC.
Entity type:Organization
Organization Name:JAMES T. MCMILLIN DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCMILLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-864-2341
Mailing Address - Street 1:7185 DAYTON SPRINGFIELD RD
Mailing Address - Street 2:P O BOX 338
Mailing Address - City:ENON
Mailing Address - State:OH
Mailing Address - Zip Code:45323-1467
Mailing Address - Country:US
Mailing Address - Phone:937-864-2341
Mailing Address - Fax:
Practice Address - Street 1:7185 DAYTON SPRINGFIELD RD
Practice Address - Street 2:WEST ENON MEDICAL CENTER
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1467
Practice Address - Country:US
Practice Address - Phone:937-864-2341
Practice Address - Fax:937-864-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300125241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty