Active NPI
Michael Brent Maggard, D.M.D., M.S.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- London, KY
National Provider Identifier
1497890339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 7280
- Practice address
- 118 W 8TH St
London, KY 40741-1714 - Phone
- (606) 877-1900
- Fax
- (606) 877-1755
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 7280 | KY | Primary |
Addresses
Primary practice location
118 W 8TH St
London, KY 40741-1714
Mailing address
118 W 8TH St
London, KY 40741-1714
Phone (606) 877-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60006566 | Medicaid | KY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7280 | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497890339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 W 8TH ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407411714",
"telephone_number": "606-877-1900",
"fax_number": "606-877-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 W 8TH ST",
"city": "LONDON",
"state": "KY",
"postal_code": "407411714",
"telephone_number": "606-877-1900",
"fax_number": "606-877-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGGARD",
"first_name": "MICHAEL",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "KY",
"license": "7280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60006566",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in London, KY
Sources for this page
- 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.