Active NPI
Misty Lynn Dedeaux, AU.D.
- Audiologist
- Biloxi, MS
National Provider Identifier
1124057138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A2217
- Practice address
- 400 Veterans Ave
Biloxi, MS 39531-2410 - Phone
- (228) 523-5480
- NPI assigned
- Jul 2, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A2217 | MS | Primary |
Addresses
Primary practice location
400 Veterans Ave
Biloxi, MS 39531-2410
Mailing address
13 Ryan Cir
Long Beach, MS 39560-2305
Phone (228) 865-0095
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 |
|---|---|---|---|
| A2217 | MS | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124057138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 RYAN CIR",
"city": "LONG BEACH",
"state": "MS",
"postal_code": "395602305",
"telephone_number": "228-865-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 VETERANS AVE",
"city": "BILOXI",
"state": "MS",
"postal_code": "395312410",
"telephone_number": "228-523-5480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDEAUX",
"first_name": "MISTY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A2217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.