Individual provider Active NPI

Malcolm E Musgrave, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1124047394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AZ3566 Issued in AZ
Practice address
1601 N Tucson Blvd Ste 30
Tucson, AZ 85716-3408
Phone
(520) 326-9693
Fax
(520) 918-9696
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AZ3566 AZ Primary

Addresses

Primary practice location

1601 N Tucson Blvd Ste 30
Tucson, AZ 85716-3408

Mailing address

1601 N Tucson Blvd Ste 30
Tucson, AZ 85716-3408
Phone (520) 326-9693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160216002102 AZ Order and Referring Only - DentistPractitioner - Dentist 9234434069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ3566AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124047394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N TUCSON BLVD STE 30",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857163408",
            "telephone_number": "520-326-9693",
            "fax_number": "520-918-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N TUCSON BLVD STE 30",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857163408",
            "telephone_number": "520-326-9693",
            "fax_number": "520-918-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGRAVE",
        "first_name": "MALCOLM",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ3566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.