Active NPI
Harold Mark Livingston, D.D.S.
- General Practice Dentistry
- Jackson, MS
National Provider Identifier
1154531754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2622-91
- Practice address
- 2500 N State St
University of Mississippi School of Dentistry
Jackson, MS 39216-4500 - Phone
- (601) 984-6028
- Fax
- (601) 984-6039
- NPI assigned
- May 23, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2622-91 | MS | Primary |
Addresses
Primary practice location
2500 N State St
University of Mississippi School of Dentistry
Jackson, MS 39216-4500
Mailing address
2500 N State St
University of Mississippi School of Dentistry
Jackson, MS 39216-4500
Phone (601) 984-6028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0660308 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160222000453 | MS | Order and Referring Only - Oral Surgery | 7113992520 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- hlivingston5962@ummc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154531754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"address_2": "UNIVERSITY OF MISSISSIPPI SCHOOL OF DENTISTRY",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-6028",
"fax_number": "601-984-6039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"address_2": "UNIVERSITY OF MISSISSIPPI SCHOOL OF DENTISTRY",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-6028",
"fax_number": "601-984-6039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVINGSTON",
"first_name": "HAROLD",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "2622-91",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0660308",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
- Live Oaks Counseling and Consulting, LLC
- Living in Full Excellence
- Living Independence for Everyone of Mississippi (LIFE of Mississippi)
- Ladean Johnson Livingston Davis, CRNA
- Darrell Rex Livingston Jr., DMD
- Livwell Alliance, LLC
- Lloyd B. Wolfe, Jr., D.M.D.
- Jacqueline Lloyd, LPC
- James Victor Nathaniel Lock II
- Robert Lock, L.P.C.
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.