Provider Demographics
NPI:1306903307
Name:MIAKININ, RONALD C (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:C
Last Name:MIAKININ
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 1:1328 ARBOR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3700
Mailing Address - Country:US
Mailing Address - Phone:248-377-2166
Mailing Address - Fax:248-652-2305
Practice Address - Street 1:4450 COLLINS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-1620
Practice Address - Country:US
Practice Address - Phone:248-652-3663
Practice Address - Fax:248-652-2305
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice