Harry J Rayburn, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

324002 Issued in MS

Practice address

627 W Main St
Tupelo, MS 38804-3732

Phone

(662) 840-0066

Fax

(662) 840-7966

NPI assigned

May 21, 2007

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

Other identifiers 1

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.

• 627 Main Tupelo Professional PLLC

  • General Practice Dentistry
  • Tupelo, MS
  • NPI 1255045019
  NPD (past)
• Main Street Family Dentistry PA

  • General Practice Dentistry
  • Tupelo, MS
  • NPI 1376623074
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407064306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 W MAIN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043732",
            "telephone_number": "662-840-0066",
            "fax_number": "662-840-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 W MAIN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043732",
            "telephone_number": "662-840-0066",
            "fax_number": "662-840-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "HARRY",
        "middle_name": "J",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "324002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660449",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Clytee Ratliff-Sorrell, LCSW
• Kara Ratliff
• Gina M Ray, MA
• Mark Ray, M.D.
• Fred Allen Rayburn Jr., FNP - BC
• Vernon A Rayford, M.D.
• Ahsan Raza, MD
• Samina Raza
• Zareen Razaq
• Ethan Razor

• General Practice Dentistry in Tupelo, MS
• Providers in Tupelo, 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 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.

Verify at the official NPI Registry.