Individual provider Active NPI

Michael William Ammons, D.M.D.

  • Dentist
  • Augusta, GA
National Provider Identifier
1356630511
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6938 Issued in SC
Practice address
1 Freedom Way
Dental Clinic, 233U
Augusta, GA 30904-6258
Phone
(843) 276-0564
Fax
(706) 481-6721
NPI assigned
Mar 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6938 SC Primary

Addresses

Primary practice location

1 Freedom Way
Dental Clinic, 233U
Augusta, GA 30904-6258

Mailing address

1 Freedom Way
Dental Clinic, 233U
Augusta, GA 30904-6258
Phone (843) 276-0564

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

Organizations & group practices 1

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1356630511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "DENTAL CLINIC, 233U",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "843-276-0564",
            "fax_number": "706-481-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "DENTAL CLINIC, 233U",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "843-276-0564",
            "fax_number": "706-481-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMONS",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "6938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.