MEDICARE: DANIELLE MILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	004147	OH
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	39235	TX

General Provider Information

NPI Number	:	1598326126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MILLER

Provider Business Mailing Address
First Line	:	4635 KINGWOOD DR STE 600
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2647
Country	:	US
Telephone Number	:	346-771-3939
Fax Number	:

Provider Business Practice Location Address
First Line	:	4635 KINGWOOD DR STE 600
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2647
Country	:	US
Telephone Number	:	646-388-4783
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	12/08/2025

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Directions to “ DANIELLE MILLER ” Practice Location

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