Individual provider Active NPI

Joan S Musgrave, DDS

  • Dentist
  • Upper Sandusky, OH
National Provider Identifier
1245333806
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19951 Issued in OH
Practice address
112 E Wyandot Ave
Upper Sandusky, OH 43351
Phone
(419) 294-3352
NPI assigned
Sep 7, 2006
Last updated
Jan 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19951 OH Primary

Addresses

Primary practice location

112 E Wyandot Ave
Upper Sandusky, OH 43351

Mailing address

112 E Wyandot Ave
Upper Sandusky, OH 43351
Phone (419) 294-3352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328000202 OH Practitioner - Oral Surgery 2567747967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19951OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical, Inc. Dentist CurrentSince Mar 1, 2017 Accepting new patients
Mobile Medical Inc Current Accepting new patients
Mobile Medical, Inc. Past Accepting new patients

Locations

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Interoperability endpoints

  • Direct secure messaging: joan.musgrave.p19@direct.360care.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1245333806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E WYANDOT AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "43351",
            "telephone_number": "419-294-3352",
            "fax_number": "419-294-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E WYANDOT AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "43351",
            "telephone_number": "419-294-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGRAVE",
        "first_name": "JOAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "19951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Sandusky, OH

Sources for this page

Verify at the official NPI Registry.