MEDICARE: DR. JAIMEE ANN MILES MICHAEL DDS

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	1223G0001X	General Practice Dentistry	12825	NC

General Provider Information

NPI Number	:	1598491987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIMEE ANN MILES MICHAEL DDS

Provider Business Mailing Address
First Line	:	1 N 16TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-4904
Country	:	US
Telephone Number	:	910-815-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 N 16TH ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-4904
Country	:	US
Telephone Number	:	910-815-0811
Fax Number	:

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

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	12/22/2022

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