Provider Demographics
NPI:1790307064
Name:MILLER, SHARI B (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:B
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 1:14110 70TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1928
Mailing Address - Country:US
Mailing Address - Phone:201-615-5381
Mailing Address - Fax:
Practice Address - Street 1:14110 70TH AVE APT 2
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1928
Practice Address - Country:US
Practice Address - Phone:201-615-5381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-10
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program