Organization Active NPI

Margo R Marveggio DMD PA

  • General Practice Dentistry
  • Vicksburg, MS
National Provider Identifier
1225202062
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2624-91 Issued in MS
Legal business name
MARGO R MARVEGGIO DMD PA
Practice address
1011 Mission 66
Vicksburg, MS 39183-2753
Phone
(601) 636-6081
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Authorized official

Name
Kathy Emerson
Title
Office Manager
Phone
(601) 636-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2624-91 MS Primary

Addresses

Primary practice location

1011 Mission 66
Vicksburg, MS 39183-2753

Mailing address

1011 Mission 66
Vicksburg, MS 39183-2753
Phone (601) 636-6081

Other identifiers 1

IdentifierTypeStateIssuer
05900018MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1225202062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832753",
            "telephone_number": "601-636-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832753",
            "telephone_number": "601-636-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARGO R MARVEGGIO DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-636-6081"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2624-91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05900018",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.