NPIMap

Organization Active NPI

Raeline K. McIntyre, DMD, P.C.

  • Dentist
  • Gulfport, MS
National Provider Identifier
1134552623
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3205-01 Issued in MS
Legal business name
RAELINE K. MCINTYRE, DMD, P.C.
Practice address
505 Cowan Rd
Gulfport, MS 39507-2024
Phone
(228) 539-5410
Fax
(228) 539-0265
NPI assigned
Aug 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Raeline K. McIntyre, DMDNPI 1205918760
Title
Owner
Phone
(228) 539-5410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3205-01 MS Primary

Addresses

Primary practice location

505 Cowan Rd
Gulfport, MS 39507-2024

Mailing address

505 Cowan Rd
Gulfport, MS 39507-2024
Phone (228) 539-5410

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1134552623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 COWAN RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395072024",
            "telephone_number": "228-539-5410",
            "fax_number": "228-539-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 COWAN RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395072024",
            "telephone_number": "228-539-5410",
            "fax_number": "228-539-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAELINE K. MCINTYRE, DMD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "RAELINE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-539-5410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "3205-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.