Philip Adam Middleton, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

347008 Issued in MS

Practice address

101 Ridgewood Cir
Kosciusko, MS 39090-3265

Phone

(662) 289-7076

Fax

(662) 289-7050

NPI assigned

Jun 24, 2008

Sex

Male

Sole proprietor

No

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.

• Autumn Ridge Dental Partnership

  • General Practice Dentistry
  • Kosciusko, MS
  • NPI 1275750531
  NPD (past)

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1366603003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 E SOUTH ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390904734",
            "telephone_number": "662-231-6911",
            "fax_number": "662-289-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIDGEWOOD CIR",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903265",
            "telephone_number": "662-289-7076",
            "fax_number": "662-289-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "PHILIP",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "347008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy McGee, P.T
• Chelsey McLendon
• Tina D McNeal, PT
• Melinda J Meacham, CFNP
• Anna Taylor Middleton, OD
• Jenni Kate Miles, MD
• Mississippi CVS Pharmacy, L.L.C.
• Mississippi Ear Nose and Throat Surgical Associates
• Mississippi State Department of Health
• Valerie Michelle Mitchell, LMSW

• General Practice Dentistry in Kosciusko, MS
• Providers in Kosciusko, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.