Raeline McIntyre, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3205-01 Issued in MS

Practice address

505 Cowan Road
Gulfport, MS 39507

Phone

(228) 539-5410

Fax

(228) 539-0265

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Raeline K. McIntyre, DMD, P.C.

  • Dentist
  • Gulfport, MS
  • NPI 1134552623
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1205918760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 COWAN ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "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 ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39507",
            "telephone_number": "228-539-5410",
            "fax_number": "228-539-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "RAELINE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3205-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyriona McGrew, RN
• Terra Rae McHugh, M.S., CCC-SLP
• Chermaine McInnis
• David Scott McIntosh, PT, OCS
• John Neil McIntyre, DMD
• Michael A McKay, M.D.
• David Anthony McKenzie, RPH
• Jennifer McKenzie
• Mineshia Shynae McKinney
• Diane M McLaughlin, LMSW

• Dentist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.