Provider Demographics
NPI:1487932307
Name:MILLER, YARON (BDS)
Entity type:Individual
Prefix:DR
First Name:YARON
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 VIA MIL CUMBRES
Mailing Address - Street 2:158
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1700
Mailing Address - Country:US
Mailing Address - Phone:858-722-8558
Mailing Address - Fax:
Practice Address - Street 1:7817 IVANHOE AVE
Practice Address - Street 2:305
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4559
Practice Address - Country:US
Practice Address - Phone:858-454-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA603371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice