Individual provider Active NPI

Braden McInteer, D.M.D.

  • General Practice Dentistry
  • Madison, MS
National Provider Identifier
1114069465
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3206-03 Issued in MS
Practice address
1896 Main St
Ste B
Madison, MS 39110-7676
Phone
(601) 898-9390
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3206-03 MS Primary

Addresses

Primary practice location

1896 Main St
Ste B
Madison, MS 39110-7676

Mailing address

1896 Main St
Ste B
Madison, MS 39110-7676
Phone (601) 898-9390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506002023 MS Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5294963526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3206-03MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Care of Madison General Practice PastSince Oct 30, 2013 Accepting new patients

Networks

  • LA PPO C-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1114069465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1896 MAIN ST",
            "address_2": "STE B",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107676",
            "telephone_number": "601-898-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 MAIN ST",
            "address_2": "STE B",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107676",
            "telephone_number": "601-898-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTEER",
        "first_name": "BRADEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3206-03",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.