Active NPI
Michael Benjamin Newsome, DDS
- General Practice Dentistry
- Roxboro, NC
National Provider Identifier
1235200106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7644NC
- Practice address
- 701 N Main St
Person Family Dental Center
Roxboro, NC 27573 - Phone
- (336) 599-9271
- Fax
- (336) 330-0247
- NPI assigned
- Nov 13, 2006
- Last updated
- Jul 8, 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 | 7644NC | NC | Primary |
Addresses
Primary practice location
701 N Main St
Person Family Dental Center
Roxboro, NC 27573
Mailing address
PO Box 350
701 N Main St Person Family Dental Center
Roxboro, NC 27573
Phone (336) 599-9271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89902RG | Medicaid | NC |
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 |
|---|---|---|---|
| 7644NC | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235200106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 350",
"address_2": "701 N MAIN ST PERSON FAMILY DENTAL CENTER",
"city": "ROXBORO",
"state": "NC",
"postal_code": "27573",
"telephone_number": "336-599-9271",
"fax_number": "336-330-0247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N MAIN ST",
"address_2": "PERSON FAMILY DENTAL CENTER",
"city": "ROXBORO",
"state": "NC",
"postal_code": "27573",
"telephone_number": "336-599-9271",
"fax_number": "336-330-0247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWSOME",
"first_name": "MICHAEL",
"middle_name": "BENJAMIN",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "7644NC",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89902RG",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.