Archusa Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ARCHUSA FAMILY DENTISTRY

Practice address

99 Highway 511
Quitman, MS 39355-8899

Phone

(601) 776-3700

NPI assigned

Apr 14, 2021

Last updated

Jul 9, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

AGELESS INTENTIONSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Reagan Danielle McNerney, DMDNPI 1518564210

Title

Owner

Phone

(601) 927-5961

Specialties & licenses 1

Addresses

Electronic endpoints 1

Part of

Archusa Family Dentistry

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reagan McNerney, D.M.D.

  • General Practice Dentistry
  • Maryville, TN
  • NPI 1518564210
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1083295844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 HIGHWAY 511",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393558899",
            "telephone_number": "601-927-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 HIGHWAY 511",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393558899",
            "telephone_number": "601-776-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHUSA FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AGELESS INTENTIONS",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "MCNERNEY",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-927-5961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "No endpoint used",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "99 Highway 511",
            "city": "Quitman",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393558899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samuel M. Allen II, M.D.
• Amedisys Mississippi, L.L.C. (Amedisys Home Health)
• Sara A. Askew, FNP
• Robin Melissa Aucoin
• Patrick Barber, D.O.
• Jennifer D. Branstetter, PHARM.D.
• Synethia Brown, FNP-BC

• General Practice Dentistry in Quitman, MS
• Providers in Quitman, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.