Active NPI
Mary Linda Remley, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Madison, MS
National Provider Identifier
1093437295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 4152-20
- Practice address
- 7724 Old Canton Rd Ste a
Madison, MS 39110-9299 - Phone
- (601) 853-1307
- NPI assigned
- Sep 14, 2022
- Last updated
- Sep 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 4152-20 | MS | Primary |
Addresses
Primary practice location
7724 Old Canton Rd Ste a
Madison, MS 39110-9299
Mailing address
709 Inheritance PL
Flowood, MS 39232-7904
Phone (601) 551-4621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4152-20 | MS | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1093437295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 INHERITANCE PL",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392327904",
"telephone_number": "601-551-4621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7724 OLD CANTON RD STE A",
"city": "MADISON",
"state": "MS",
"postal_code": "391109299",
"telephone_number": "601-853-1307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REMLEY",
"first_name": "MARY",
"middle_name": "LINDA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MS",
"license": "4152-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.