Active NPI
Diana Marie Long, DDS
- Dentist
- Madison, MS
National Provider Identifier
1124391347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3757
- Practice address
- 504 Newbury Dr
Madison, MS 39110-4574 - Phone
- (256) 335-7042
- NPI assigned
- Feb 18, 2012
- Last updated
- Nov 28, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 6018 | AL | |
| Dentist | 122300000X | 3757 | MS | Primary |
Addresses
Primary practice location
504 Newbury Dr
Madison, MS 39110-4574
Mailing address
504 Newbury Dr
Madison, MS 39110-4574
Phone (256) 335-7042
Other names 1
- Diana Long Pappa
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 |
|---|---|---|---|
| 3757 | MS | MD | Dentist |
| 6018 | AL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madison Dental Studio | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Madison, MS
- NPI 1083225189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1124391347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 NEWBURY DR",
"city": "MADISON",
"state": "MS",
"postal_code": "391104574",
"telephone_number": "256-335-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 NEWBURY DR",
"city": "MADISON",
"state": "MS",
"postal_code": "391104574",
"telephone_number": "256-335-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "DIANA",
"middle_name": "MARIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-18",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "6018",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "3757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANA",
"last_name": "PAPPA",
"middle_name": "LONG",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}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 Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.