Individual provider Active NPI

Emmett R McLane, DDS

  • General Practice Dentistry
  • Farmville, VA
National Provider Identifier
1154496610
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401005617 Issued in VA
Practice address
400 Longwood Ave # a
Farmville, VA 23901-1524
Phone
(434) 392-5377
Fax
(434) 392-1541
NPI assigned
Nov 21, 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 0401005617 VA Primary

Addresses

Primary practice location

400 Longwood Ave # a
Farmville, VA 23901-1524

Mailing address

400 Longwood Ave # a
P O Box 909
Farmville, VA 23901-1524
Phone (434) 392-5377

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

LicenseStateTypeSpecialty
0401005617VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154496610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LONGWOOD AVE # A",
            "address_2": "P O BOX 909",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011524",
            "telephone_number": "434-392-5377",
            "fax_number": "434-392-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LONGWOOD AVE # A",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011524",
            "telephone_number": "434-392-5377",
            "fax_number": "434-392-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLANE",
        "first_name": "EMMETT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401005617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, VA

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.

Verify at the official NPI Registry.