Provider Demographics
NPI:1336275676
Name:MILLER, MATTHEW AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:AARON
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 1:626 CARLISLE WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3425
Mailing Address - Country:US
Mailing Address - Phone:408-505-4383
Mailing Address - Fax:
Practice Address - Street 1:777 CUESTA DR STE 140
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3765
Practice Address - Country:US
Practice Address - Phone:650-965-2313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice