Joseph Boone, D.M.D.
Individual provider Active NPI General Practice Dentistry · Clinton, MS
NPI 1770925398 · NPPES record last updated Jul 24, 2013
Key facts
- NPI
- 1770925398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 371713 (MS)
- Practice address
- 315 Morrison Dr
Clinton, MS 39056-5239 - Phone
- (601) 925-5163
- Fax
- (601) 925-5184
- NPI assigned
- Jul 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160907001214 | MS | Order and Referring Only - Dentist |
5597051235 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 371713 | MS | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 371713 | MS | Yes |
Addresses
Primary practice location
315 Morrison Dr
Clinton, MS 39056-5239
Mailing address
315 Morrison Dr
Clinton, MS 39056-5239
Phone (601) 925-5163
Other providers in Clinton, MS
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- Donan Boggess
- Patrick Lynn Boler
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- Spencer K Boothe
- Blake Bostick
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All providers in Clinton, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.