Active NPI
Charles Austin Huffman, DMD
- Dentist
- Jackson, MS
National Provider Identifier
1619595295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4111-20
- Practice address
- 1189 E County Line Rd
Jackson, MS 39211-1836 - Phone
- (601) 308-2022
- NPI assigned
- Jul 9, 2020
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4111-20 | MS | Primary |
Addresses
Primary practice location
1189 E County Line Rd
Jackson, MS 39211-1836
Mailing address
741 Chickasaw Ave
Jackson, MS 39206-5810
Phone (662) 610-5174
Other practice location 1
2300 N Hills St
Meridian, MS 39305-2633
Phone (601) 474-3140
Other practice location 2
310 W Woodrow Wilson Ave
Jackson, MS 39213-7696
Phone (769) 230-1940
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 |
|---|---|---|---|
| 4111-20 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Happy Smiles Dentistry-Meridian LLC | Past | Accepting new patients | |
| Smile Straight Orthodontics-Central Ms PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Meridian, MS
- NPI 1326395799
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Meridian, MS
- NPI 1790318608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1619595295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "741 CHICKASAW AVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "392065810",
"telephone_number": "662-610-5174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1189 E COUNTY LINE RD",
"city": "JACKSON",
"state": "MS",
"postal_code": "392111836",
"telephone_number": "601-308-2022"
}
],
"practiceLocations": [
{
"address_1": "2300 N Hills St",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "MS",
"postal_code": "393052633",
"country_code": "US",
"telephone_number": "601-474-3140",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "310 W Woodrow Wilson Ave",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392137696",
"country_code": "US",
"telephone_number": "769-230-1940",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUFFMAN",
"first_name": "CHARLES",
"middle_name": "AUSTIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "4111-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.