Elyse Miller, D.D.S.
Dentist in San Diego, CA. Individual provider (NPI-1).
NPI number1407239288
StatusActive
Last updated in NPPESFeb 11, 2025
Details
- NPI
- 1407239288
- Entity type
- Individual (NPI-1)
- Name
- Elyse Miller
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2015
- Certification date
- Feb 11, 2025
- Last updated
- Feb 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - OTHER (PHYSICIAN)
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D009238 | AZ | Yes |
| 122300000X | Dentist | 107145 | CA |
Practice location
9135 Buckwheat StSan Diego, CA 92129-3643
Phone 847-946-8738
Mailing address
9135 Buckwheat StSan Diego, CA 92129-3643
Phone 847-946-8738
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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