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DR. MARK D. MILLER DDS
NPI 1104982016
Dentist - Oral and Maxillofacial Surgery in Louisville, KY

Active since December 28, 2006PECOS Enrolled
1211 W BROADWAY UNIT 106, LOUISVILLE, KY 40203(270) 885-0165(270) 886-2224 Get Directions Write a Review

NPPES record last updated: June 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 24, 2020, May 28, 2020 (2 updates tracked since 2020).

About Dr. Mark D. Miller Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK D. MILLER DDS (NPI 1104982016) is an individual oral and maxillofacial surgery provider in Louisville, Kentucky, licensed in Kentucky (6861) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Texarkana.

NPPES Registry Identity

NPI1104982016
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MARK D. MILLERCredential: DDS
Location Address1211 W BROADWAY UNIT 106Louisville, KY 40203-2082
Mailing Address15142 Rosario RdFrisco, TX 75035-5439 · (270) 889-3686
Phone(270) 885-0165
Fax(270) 886-2224
Sole ProprietorNo
Enumeration DateDecember 28, 2006
Last NPPES UpdateJune 24, 20202 updates tracked since enumeration
NPPES CertifiedJune 24, 2020
✔ NPI 1104982016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in KY · 6861✔ Licensed in TX · 36087
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentist · Dentist AnesthesiologistTaxonomy 1223D0004X · License 6861 (KY)
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 6861 (KY)
1211 W BROADWAY UNIT 106, Louisville, KY 40203
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Secondary Practice Location 1

Location 12400 Richmond Rd Ste 133Texarkana, TX 75503-2464 · Phone (903) 306-0790 · Fax (903) 831-9940

Other Identifiers 2

Medicaid60068616KY
Medicaid64068612KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Buckeye Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark D. Miller Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Miller's NPI number?

The NPI number for Mark Miller is 1104982016. It was assigned to this individual provider in the NPPES registry on December 28, 2006.

Where is Mark Miller located?

Mark Miller practices at 1211 W Broadway Unit 106, Louisville, KY 40203. The listed phone number is (270) 885-0165.

What is Mark Miller's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Mark Miller enrolled in Medicare?

Yes. Mark Miller is registered in the Medicare PECOS enrollment system.

What insurance does Mark Miller accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Buckeye Health Plan and Ambetter from Home State Health and 12 other insurers list Mark Miller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Miller was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.