Active NPI
Susann McMahen, DDS
- Dentist
- Ruston, LA
National Provider Identifier
1154772051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6686
- Practice address
- 306 E Reynolds Dr
Suite 1
Ruston, LA 71270-2846 - Phone
- (318) 255-6780
- NPI assigned
- Jun 22, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6686 | LA | Primary |
Addresses
Primary practice location
306 E Reynolds Dr
Suite 1
Ruston, LA 71270-2846
Mailing address
2564 Melody LN
Ruston, LA 71270-2551
Phone (318) 423-1603
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 |
|---|---|---|---|
| 6686 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnston Dental Care | Dentist | Past | 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 and National Provider Directory roles.
-
- Dentist
- Ruston, LA
- NPI 1710336862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466553600000",
"number": "1154772051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2564 MELODY LN",
"city": "RUSTON",
"state": "LA",
"postal_code": "712702551",
"telephone_number": "318-423-1603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 E REYNOLDS DR",
"address_2": "SUITE 1",
"city": "RUSTON",
"state": "LA",
"postal_code": "712702846",
"telephone_number": "318-255-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHEN",
"first_name": "SUSANN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-22",
"last_updated": "2016-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.