Macgregor Enterprises LLC

Primary specialty

DentistTaxonomy code 122300000X

License

0401005891 Issued in VA

Legal business name

MACGREGOR ENTERPRISES LLC

Practice address

703 Thimble Shoals Blvd
Suite C-3
Newport News, VA 23606-2576

Phone

(757) 594-9005

Fax

(757) 594-9215

NPI assigned

Apr 25, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda L Tillage

Title

Office Manager

Phone

(757) 594-9005

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1407021934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 THIMBLE SHOALS BLVD",
            "address_2": "SUITE C-3",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062576",
            "telephone_number": "757-594-9005",
            "fax_number": "757-594-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 THIMBLE SHOALS BLVD",
            "address_2": "SUITE C-3",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062576",
            "telephone_number": "757-594-9005",
            "fax_number": "757-594-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACGREGOR ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "TILLAGE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-594-9005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401005891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245250927",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Catherine Lynn, DDS
• Jason Eli Maas, MD, PHD
• Joel Verano Mabalot, MD
• Kathleen Mabis
• Kelli Lyn Macadam, CNM
• Steven E Mack, M.D.
• Tierra Mack, RBT
• Susan Elizabeth Mackel, MD
• Thomas Alexander Mackenzie, MD
• Robert Thad Mackie, D.D.S.

• Dentist in Newport News, VA
• Providers in Newport News, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.