Provider Demographics
NPI:1821087032
Name:MILLER, GREGORY JONATHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JONATHAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9223 QUINTANA DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2001
Mailing Address - Country:US
Mailing Address - Phone:301-365-2606
Mailing Address - Fax:301-365-2606
Practice Address - Street 1:7723 ALASKA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1458
Practice Address - Country:US
Practice Address - Phone:202-882-7878
Practice Address - Fax:202-882-4948
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN43421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice