Provider Demographics
NPI:1396372736
Name:MILLER, ALINA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALINA
Middle Name:MARIA
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 1:11507 E 37TH TER S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-2520
Mailing Address - Country:US
Mailing Address - Phone:559-916-9520
Mailing Address - Fax:
Practice Address - Street 1:1205 NE CORONADO DR
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2928
Practice Address - Country:US
Practice Address - Phone:816-228-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200417891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice