Provider Demographics
NPI:1801403555
Name:MILLER, STEPHANIE ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELIZABETH
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 1:2220 SISTERS AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4394
Mailing Address - Country:US
Mailing Address - Phone:630-922-1643
Mailing Address - Fax:
Practice Address - Street 1:2220 SISTERS AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4394
Practice Address - Country:US
Practice Address - Phone:630-303-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190327491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice