Clyde Armstrong Musgrave, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3136-00 Issued in MS

Practice address

3964 Goodman Rd E Ste 128
Southaven, MS 38672-6494

Phone

(662) 893-7337

Fax

(662) 893-7881

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• North Mississippi Dental Specialists, PLLC

  dba the children's dental center

  • Pediatric Dentistry
  • Southaven, MS
  • NPI 1578658373
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1194825299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 NAIL RD E",
            "address_2": "SUITE 103",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726620",
            "telephone_number": "662-893-7337",
            "fax_number": "662-893-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD E STE 128",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726494",
            "telephone_number": "662-893-7337",
            "fax_number": "662-893-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGRAVE",
        "first_name": "CLYDE",
        "middle_name": "ARMSTRONG",
        "name_prefix": "Prof.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "3136-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660434",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MSK Group, PC (OrthoSouth)
• Madeline Murphy
• Natalie Murphy, SLP
• William Murphy
• Leah Murray, OTR/L
• Aliza Mushtaq
• Ayesha Muzammil, MD
• My Brother's Keeper Homecare Solutions, LLC
• Patrice Myles, CPT
• Deanna Nabors, MD

• Pediatric Dentistry in Southaven, MS
• Providers in Southaven, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.