Catherine Johnson Mincy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3009-97 Issued in MS

Legal business name

CATHERINE JOHNSON MINCY, DDS

Practice address

607 W Church St
Booneville, MS 38829-2647

Phone

(662) 728-8133

Fax

(662) 728-6903

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Catherine Johnson Mincy, DDSNPI 1679627335

Title

Owner

Phone

(662) 728-8133

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CATHERINE JOHNSON MINCY, DDS Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine Johnson Mincy, DDS

  • General Practice Dentistry
  • Booneville, MS
  • NPI 1679627335
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790801298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292647",
            "telephone_number": "662-728-8133",
            "fax_number": "662-728-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292647",
            "telephone_number": "662-728-8133",
            "fax_number": "662-728-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHERINE JOHNSON MINCY, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MINCY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-728-8133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3009-97",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660215",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CATHERINE JOHNSON MINCY, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Stephanie Ann Butler Flake, RN
• Hanna Byrd, CFNP
• Clifton C Cartwright, M.D.
• Clifton Wesley Cartwright, FNP-BC
• Pam Castle, PCMHT
• Elizabeth Caver
• Charles D. Johnson, DDS
• David G Chase Sr., M.D.
• Meagan Cherry, NP
• Wendy Chisholm, CMHT

• General Practice Dentistry in Booneville, MS
• Providers in Booneville, 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 Aug 22, 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.

Verify at the official NPI Registry.