1639360001 NPI number — DR. CLAUDIA PATRICIA MILLAN DDS

Table of content: DR. CLAUDIA PATRICIA MILLAN DDS (NPI 1639360001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639360001 NPI number — DR. CLAUDIA PATRICIA MILLAN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLAN
Provider First Name:
CLAUDIA
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GUZMAN
Provider Other First Name:
CLAUDIA
Provider Other Middle Name:
PATRICIA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639360001
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BLDG 38801, ACADEMIC DR. SUITE B, FORT EISENHOWER
Provider Second Line Business Mailing Address:
US ARMY DENTAL COMMAND
Provider Business Mailing Address City Name:
FORT EISENHOWER
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30080-7533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-419-0088
Provider Business Mailing Address Fax Number:
210-221-0824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 E HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT EISENHOWER
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905-6011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-419-0088
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  23409 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0300X , with the licence number: 23409 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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