Provider Demographics
NPI:1164672002
Name:MILLER, AMANDA RACHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:RACHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:RACHELLE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7028 HYLAND HILLS ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8716
Mailing Address - Country:US
Mailing Address - Phone:303-746-9137
Mailing Address - Fax:
Practice Address - Street 1:19700 E PARKER SQUARE DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7301
Practice Address - Country:US
Practice Address - Phone:720-370-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-97571223G0001X
CO9757122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice